CATARACT SURGERY
Ways to Educate Patients on ATIOLs this Cataract Awareness Month
5 minute read
As a cataract surgeon with over twenty-five years of experience, I have helped over 50,000 patients make their way through the ever-growing list of intraocular lenses (IOLs) to determine which lens is the best choice for their post-surgery vision goals, lifestyle and financial situation. With the advent of ATIOLs, this process has become more difficult for patients to navigate because it requires a greater understanding of their eye health and the spectrum of options available to reach their vision goals.
This presents a ripe opportunity to help patients select a more advanced IOL that can offer the ability to correct their vision, including the opportunity to reduce their spectacle dependence.1-3
Implementing Patient Education in Your Own Practice
Implementing patient education may seem easier said than done. I have spent decades honing my process for pre-and post-op patient education. Even though I am proud of the education I offer my patients, I would have welcomed the opportunity to have some help along the way. The Alcon Accelerator program does just that.
Alcon Accelerator is a value-added program that provides surgeons with comprehensive tools and resources, focused on the patient journey and guiding patients to make knowledgeable decisions—so surgeons no longer need to “reinvent the wheel” when it comes to actualizing patient education in their practices.
Components of the Alcon Accelerator program include patient education among four distinct categories that help your practice and patients feel comfortable with the technologies available:
Case Study: The “Unicorn” Patient
In my own practice, I have devised a three-fold approach to patient education that closely aligns with Alcon Accelerator. It begins with education that fosters understanding which allows the patient to more effectively participate in the decision-making process, and ends with my strong recommendation on one or two IOL options based on what I know they personally value in their vision outcomes.
To better illustrate this, let’s look at a recent case study that I was faced with in my practice.
Let’s call this patient the Unicorn.
A 65-year-old woman requested Clareon® Vivity® because she had heard great things about it from her neighbor. After asking her three simple questions, it became clear that even though she was exposed to ATIOL technology before the appointment, her understanding was incomplete.
This Unicorn patient rarely wore glasses, including for reading. However, Clareon Vivity would almost certainly require her to wear reading glasses.1 Had she received Vivity®, it may have caused a change in her lifestyle that may have led to reduced post-surgical satisfaction. We have all encountered patients who think they know what they want, so what makes this patient a unicorn?
The reason is this: rather than giving this patient the lens she initially asked for, I was able to intervene and help her select the IOL that would better meet her expectations, Clareon® PanOptix®, which offers greater independence from glasses.2,3 This is the “Educate” component of the Alcon Accelerator program, which seeks to improve the patient experience through effective education, even when patients come in with background knowledge.
How Surgeons Can Encourage Patients to Pivot
A series of simple questions can help to better understand your patients and to determine the best technology to meet their expectations:
- Have you ever had eye surgery (LASIK, etc.) before?
- Do you wear glasses? If so, do you wear them all the time (walking around the house, driving at night, etc.), or do you take them off to read?
- If I could make your vision so that you would still need reading glasses but never need them for anything else, would that be okay?
Questions like these can help you to understand how the patient is currently using their eyes, where they are expecting to use glasses post-surgery, and if they are they motivated to seek out advanced technology.
These questions can also help patients understand there is not a one-size-fits-all solution and that the decision for each individual will be a collaborative one between the patient and the surgeon.
Making Strong Recommendations
Once you have determined that a patient is a candidate for an ATIOL and understand what they find valuable in their vision, the next step is making a strong recommendation based on what you have learned. This is the “Demonstrate” portion of the Alcon Accelerator and involves leveraging your value-based conversations with patients to highlight how an ATIOL like Clareon® PanOptix® and Clareon® Vivity® can help them maintain or improve what they value most in their vision.1,3
When making these recommendations, try not to get too detailed in the explanation of the technology—this can overwhelm patients who may already be weary. Instead, break down their options in simpler terms that focus on how their vision will most likely function after surgery.
Managing Patient Expectations
Any recommendation should also come with a clear explanation of the potential side effects for each option you recommend, as well as an explanation of how the balance of side effects and benefits can be customized for each patient. Setting expectations is an important piece of the “Evaluate” component of the Accelerator Program, which aims to prevent and eliminate some of patients’ most common post-op pain points.
Customizing an Approach for Your Practice
Implementing all these pearls of wisdom on your own is no easy task. That’s where Alcon Accelerator and other Alcon educational resources come in.
Just like IOLs, Alcon Accelerator is not a one-size-fits-all program. Through an initial practice assessment that focuses on the patient journey and the unique needs of your practice, Alcon can effectively partner with you and your staff to implement resources that increase patient education and optimize Alcon ATIOL outcomes.
As a committed partner to practices and their patients, Alcon also has a comprehensive library of printed and digital ATIOL educational resources. There is no better time for you to get started exploring the options to expand your patient education efforts than Cataract Awareness Month.
If you are interested in ways that you can improve patient satisfaction through elevated patient education tools that expand the use of ATIOL such as Clareon® Vivity® and Clareon® PanOptix® in your practice, reach out to your Alcon Sales Representative.
IMPORTANT PRODUCT INFORMATION: CLAREON® PANOPTIX® AND VIVITY® FAMILY OF IOLS
CAUTION: Federal (USA) law restricts this device to the sale by or on the order of a physician.
INDICATIONS:
The Clareon® PanOptix® Trifocal Hydrophobic IOL, Clareon® PanOptix® Toric, Clareon® Vivity® Extended Vision Hydrophobic Posterior Chamber IOL and Clareon® Vivity® Toric IOLs are indicated for visual correction of aphakia in adult patients following cataract surgery. In addition, the Clareon® Toric IOLs are indicated to correct pre-existing corneal astigmatism at the time of cataract surgery. The Clareon® PanOptix® lens mitigates the effects of presbyopia by providing improved intermediate and near visual acuity, while maintaining comparable distance visual acuity with a reduced need for eyeglasses, compared to a monofocal IOL. The Clareon® Vivity® lens mitigates the effects of presbyopia by providing an extended depth of focus. Compared to an aspheric monofocal IOL, the lens provides improved intermediate and near visual acuity, while maintaining comparable distance visual acuity. All of these IOLs are intended for placement in the capsular bag.
WARNINGS/PRECAUTIONS: Careful preoperative evaluation and sound clinical judgment should be used by the surgeon to decide the risk/benefit ratio before implanting a lens in a patient with any of the conditions described in the Directions for Use labeling. Physicians should target emmetropia, and ensure that IOL centration is achieved.
For the PanOptix® Toric and Vivity® IOLs, the lens should not be implanted if the posterior capsule is ruptured, if the zonules are damaged, or if a primary posterior capsulotomy is planned. Rotation can reduce astigmatic correction; if necessary lens repositioning should occur as early as possible prior to lens encapsulation.
For the Clareon® PanOptix® IOL, some visual effects may be expected due to the superposition of focused and unfocused multiple images. These may include some perceptions of halos or starbursts, as well as other visual symptoms. As with other multifocal IOLs, there is a possibility that visual symptoms may be significant enough that the patient will request explant of the multifocal IOL. A reduction in contrast sensitivity as compared to a monofocal IOL may be experienced by some patients and may be more prevalent in low lighting conditions. Therefore, patients implanted with multifocal IOLs should exercise caution when driving at night or in poor visibility conditions. Patients should be advised that unexpected outcomes could lead to continued spectacle dependence or the need for secondary surgical intervention (e.g., intraocular lens replacement or repositioning). As with other multifocal IOLs, patients may need glasses when reading small print or looking at small objects. Posterior capsule opacification (PCO), may significantly affect the vision of patients with multifocal IOLs sooner in its progression than patients with monofocal IOLs.
For the Clareon® Vivity® IOL, most patients implanted with the Vivity® IOL are likely to experience significant loss of contrast sensitivity as compared to a monofocal IOL. Therefore, it is essential that prospective patients be fully informed of this risk before giving their consent for implantation of the Clareon® Vivity® IOL. In addition, patients should be warned that they will need to exercise caution when engaging in activities that require good vision in dimly lit environments, such as driving at night or in poor visibility conditions, especially in the presence of oncoming traffic. It is possible to experience very bothersome visual disturbances, significant enough that the patient could request explant of the IOL. In the parent AcrySof® IQ Vivity® IOL clinical study, 1% to 2% of AcrySof® IQ Vivity® IOL patients reported very bothersome starbursts, halos, blurred vision, or dark area visual disturbances; however, no explants were reported. Prior to surgery, physicians should provide prospective patients with a copy of the Patient Information Brochure available from Alcon informing them of possible risks and benefits associated with these IOLs.
ATTENTION: Reference the Directions for Use labeling for each IOL for a complete listing of indications, warnings and precautions.
References:
- Clareon® Vivity® Directions for Use
- Zhu D, Ren S, Mills K, Hull J, Dhariwal M. Rate of Complete Spectacle Independence with a Trifocal intraocular lens: A systematic literature review and meta-analysis. Ophthalmol Ther. 2023 Apr;12(2):1157-1171. doi: 10.1007/s40123-023-00657-5. Epub 2023 Feb 6. PMID: 36745314; PMCID: PMC10011212.
- Clareon® PanOptix® Directions for Use
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