My most difficult patient. Augenrzte Gerl, Kretz & Kollegen - - PowerPoint PPT Presentation

www.augenklinik.de

Augenärzte Gerl, Kretz & Kollegen Head Office Am Schloßgraben 13 48683 Ahaus Germany Email: f.kretz@augenklinik.de Tel.: +49-2561-9555675

Provisus Research Institute

My most difficult patient.

Financial Disclosure

Acufocus1 Alimera2,3,4 AMO1,2,3 AVS1 Carl Zeiss Meditec1,2,3,4 Glaukos 1,2,3,4 Hoya1 LensAR1 Mediphacos1 MST4 Oculentis1,2,3,4 ODC4 PhysIOL1 Polytech1,2,3,4 Santen1 Teleon1,2,3 Vision Ophthalmology Group2,3,4

1 = Research; 2 = Travel Expenses 3 = Honorary; 4 = Consulting

Univ.- Augenklinik Universität Heidelberg

Cooperations

Provisus Research Institute

Provisus Research Institute

My mother as my patient

• 60year old patient
• Cataracta subcapsularis posterior after systemic steroid

treatment

• Wish for spectacle independancy
• UDVA: OD = 0.4 logMAR; OS = 0.3 logMAR
• CDVA: OD = 0.3 logMAR; OS = 0.2 logMAR
• SE: OD = +1.25D; OS = +1.0D

Provisus Research Institute

Her demands

• Absolute spectacle independency (she is a difficult

person)

• Working with her horses and driving her horse

trailer

• Contacting and interacting with her Children and

Grandchildren via iPad or Laptop

• Reading books

Provisus Research Institute

Which IOL to choose for my mother

Preoperative measurements

IOL Master 700

• Axial length: OD = 22.68mm;

OS = 22.55mm

• Keratometry:
• OD: R1 = 7.35mm, 166°;

R2 = 7.21mm , 76°

• 0.86D 166°
• OS: R1 = 7.36mm, 176°;

R2 = 7.24mm, 86°

• 0.74D 176°

Provisus Research Institute

Which IOL to choose for my mother

•  EDoF IOL as she loves reading books
•  EDoF Micro- or Nanovision as she needs binocularity for her horse trailer
•  PhysIOL Finevision as the apodisation decreases near vision under dim

light conditions

•  Bifocal higher add power IOL as she would have a lack of intermediate

vision

Provisus Research Institute

Which IOL to choose for my mother

Preoperative measurements

IOL Master 700

• Axial length: OD = 22.68mm; OS = 22.55mm
• Keratometry:
• OD: R1 = 7.35mm, 166°; R2 = 7.21mm , 76°
• 0.86D 166°
• OS: R1 = 7.36mm, 176°; R2 = 7.24mm, 86°
• 0.74D 176°

Toric or non-toric IOL ????? Or just tell her to find a different doctor?

Provisus Research Institute

My choice for my mother

I felt confident: I decided for an AT LISA tri toric 939MP with simultaneous surgery

• Known good outcomes for all distances
• No appodisation
• Enhanced distance light distribution in nighttime pupil conditions by keeping

reading ability Selected IOLs: OD: +20.00D sphere, +1.00D cyl, 76° OS: +20.50D sphere, +1.00D cyl. 86°

Provisus Research Institute

My choice for my mother

An AT LISA tri toric 939MP was implanted in both eyes in a single procedure on the 24th of August 2016 in general anesthesia Post-Op Result

• 1 day:UDVA: OD 0.0 logMAR, OS: 0.1 logMAR

–UNVA: OD/OS 0.0 logMAR

• 1 week to 20 month:

UDVA: OD -0.1 logMAR, OS: 0.0 logMAR –binocular UDVA: -0.1 logMAR –UNVA: OD -0.1 logMAR, OS: 0.0 logMAR –binocular UNVA: -0.1 logMAR –binocular UIVA in 75cm: 0.0 logMAR

It worked and she still loves me and feels much better now!!!

Provisus Research Institute

Conclusion

• Various Options for individualized patient care available
• Trifocal IOLs offer a wide range of vision from distance to

near

• AT LISA tri was a perfect choice for my mother

And she still loves and even came to Cambodia to support our philantrophy project in 2017.

Thank you very much for

Your Attention!

Augenärzte

Gerl, Kretz & Kollegen

• Dr. med. Florian T. A. Kretz, FEBO

Email: f.kretz@augenklinik.de Tel.: +49-2561-9555675 Head Office Am Schloßgraben 13 48683 Ahaus Germany

Provisus Research Institute

Follow us on

@drkretz @KretzDr