Pre-Operative Testing
What Types of Screening Exams Should Patients Expect? Anyone considering PCIOLs will undergo a thorough examination by an eye care professional. The exam and a follow-up consultation with the physician should:
  • Identify ongoing health concerns that may affect your vision in the future
  • Inform you of potential outcomes of surgery
  • Frame your expectations for what the procedure can do
  • Inform you of your vision health status

Assessment of Eye Health History

History of wearing glasses:

  • It is important to determine if a candidate's vision has stabilized or is changing. If unstable, surgery may not be appropriate at this time
  • The ideal candidate is at least 18 years of age with a stable history of wearing prescription glasses or contact lens prescriptions for at least two years
History of wearing contact lenses:
  • Contact lenses may change the shape of the cornea, the clear front surface of the eye, or act in such a way as to prevent the ophthalmologist from determining a candidate's correct prescription
  • Most ophthalmologists require that soft contact lenses be discontinued at least three days and rigid contact lenses two to three weeks prior to the evaluation
  • If concern arises about contact lens-induced changes in the cornea, it may be necessary for a candidate to stop wearing contacts for several months to allow the cornea to return to its natural contour, so that a surgical evaluation can be made
History of ocular or systemic diseases and medications:
  • Some eye diseases and medications can affect the suitability of a candidate for surgery
  • History of previous ocular problems such as lazy eyes, strabismus (eye misalignment caused by muscle imbalance), or the need for special glasses to prevent double vision
  • History of previous eye injury
Get the Facts: Assessing Vocational and Lifestyle Needs
The candidate's work or recreational activities and needs can influence vision correction strategies. For example, different strategies can affect depth perception and the ability to see near or far.

A Comprehensive Examination of the Eye Typically Includes:
  • Determination of uncorrected vision and vision as corrected by glasses or contacts
  • Determination of the magnitude of visual error in each eye to establish the amount of surgical correction that is needed and to develop the appropriate surgical strategy
  • Assessment of the surface of the cornea by “mapping” its topography (corneal curvature or shape), to correlate its shape to errors in focusing (correlate corneal shape to refractive astigmatism), to find irregularities, if any, and to screen for disease states that may produce poor outcomes
  • Measurement of pupil size in dim room light. Pupil size may be an important factor in counseling a candidate about night vision and planning the appropriate vision correction strategy
  • Assessment of motility to measure the ability of the muscles to align the eyes
  • Examination of the eyelids to see if they turn inward?possibly scratching the cornea?or outward and redirect tear flow away from the eye, and other conditions
  • Examination of the conjunctiva, the transparent membrane that covers the outer surface of the eye and lines the inner surface of the eyelids, to see whether there are irritations, redness, irregular blood vessels or other abnormalities
  • Examination of the crystalline lens to determine if clouding of the lens (cataract) or other abnormalities are present
  • Measurement of corneal thickness (pachymetry)
  • Measurement of intraocular pressure to detect glaucoma or pre-glaucomatous conditions. Glaucoma is a visual loss caused by damage to the optic nerve from excessively high pressures in the eye. It is a common cause of preventable vision loss
  • Assessment of the back (posterior segment) of the eye. The dilated fundus exam is used to assess the health of the inside back surface of the eye (retina), with the pupil fully open. Examination of the retina, optic nerve, and blood vessels screens for a number of eye and systemic disorders
  • Follow-up should include review of examination results by an ophthalmologist, discussion with the candidate, additional testing as necessary and adoption of a plan for managing the candidate's eye-care needs
Get the Facts
Additional testing, depending on preliminary findings and the special needs of the candidate, may also be appropriate. If, after an evaluation, a patient has questions about why a test was included or omitted, he or she should discuss the matter with an eye care professional. A patient can and should question why a test was omitted. The patient should be satisfied with the explanation before proceeding.

Realistic Expectations: Why Are They Central to Patient Satisfaction? The overwhelming majority of patients who have had IOL surgery are satisfied with their results’ having experienced the significant benefits of improved vision. However, as with any medical or surgical procedure, for certain patients the outcome of the procedure may not seem “ideal” or meet all of his or her expectations. A small minority of patients may also experience complications. Therefore, it is crucial that surgical candidates thoroughly discuss the procedure it benefits, risks and probable outcomes with their physician prior to undergoing the surgery. Each patient should be fully informed and feel comfortable that they are making an educated decision based upon facts. Candidates should be aware that:
PCIOLs cannot provide perfect vision every time for every patient
  • For the majority of patients, the surgery improves vision and reduces the need for corrective eyewear
  • The vast majority of patients with low to moderate nearsightedness achieve 20/40 vision or better and many may achieve 20/20 vision or better
There may be visual aberrations after PCIOL implant surgery
  • Most commonly, glare and halos under dim lighting conditions. Usually, these are not significant and resolve within several months of surgery
  • There may be a rare case of an individual who has glare or halos that are severe enough to interfere with normal activities
PCIOLs are intended to be permanent
  • Although, they can be removed surgically, vision may not return to what it was before receiving the lenses
Lens implant surgery, as all surgical procedures, has the risk of complications
  • The likelihood of visual loss with such procedures is very small
  • Millions of IOLs implanted each year to restore vision after cataract surgery
  • Less than one percent of patients have experienced serious, vision threatening problems
  • Most complications represent delays in full recovery and resolve within several months of surgery
Harris Poll Survey on Vision
The American Society of Cataract and Refractive Surgery recently completed a Harris Interactive Survey of the general population, aged 45 + and patients who have had vision correction surgery to manage presbyopia. See how their experiences match yours. >>