Provisus Research Institute www.augenklinik.de My most difficult patient. Augenärzte Gerl, Kretz & Kollegen Head Office Am Schloßgraben 13 Email: f.kretz@augenklinik.de 48683 Ahaus Tel.: +49-2561-9555675 Germany
Financial Disclosure Cooperations Acufocus 1 MST 4 Alimera 2,3,4 Oculentis 1,2,3,4 AMO 1,2,3 ODC 4 AVS 1 PhysIOL 1 Carl Zeiss Meditec 1,2,3,4 Polytech 1,2,3,4 Glaukos 1,2,3,4 Santen 1 Hoya 1 Teleon 1,2,3 LensAR 1 Vision Ophthalmology Mediphacos 1 Group 2,3,4 1 = Research; 2 = Travel Expenses 3 = Honorary; 4 = Consulting Univ.- Augenklinik Universität Heidelberg 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 Or just tell her to find a different doctor? 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 ????? 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 24 th of August 2016 in general anesthesia It worked and she still loves me and feels much better now!!! 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 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. Provisus Research Institute
Provisus Research Institute 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 Follow us on Head Office Am Schloßgraben 13 48683 Ahaus Germany @drkretz @KretzDr
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