CataractCoach™ 2297: hyperopia on the brain! pearls for cataract surgery in hyperopes скачать в хорошем качестве

CataractCoach™ 2297: hyperopia on the brain! pearls for cataract surgery in hyperopes

People like what they like, what they are used to, what just feels right. That applies for many things in life including refractive considerations. Have you ever seen a patient wearing spectacles with the astigmatic correction at a suboptimal axis and yet the patient prefers that over the correct refraction that would yield better vision? When we do refractive planning for patients who have a lifetime of hyperopia, whether latent or manifesting, we must remember that these patients do not know what it is like to be even slightly myopic. Imagine a patient with "perfect vision" until about age 45 when presbyopia hits and then when the patient is 60 glasses are now needed for distance vision too. This patient was likely a mild latent hyperope with a refraction of +1 to +2 in youth but because of the abundance of accommodative amplitude, that was easily dialed in to sharp distance and near vision for many decades. As the ability to accommodate wanes in the mid 40s, the patient now starts to use reading glasses while the distance vision is still good because of the remaining 1 to 2 diopters of accommodation. Fast forward to age 60 and no more accommodation and the patient now needs +1.50 for distance vision and another +2.50 on top of that for near vision. Now the patient presents to you at age 70 for cataract surgery with a monofocal IOL: what is your refractive target? Will you choose -0.50, plano, or +0.50?