RISING STANDARD

It's time to let the concept of “premium” IOLs and cataract surgery die a natural death, Keiki R Mehta MD told the 2013 Congress of the ESCRS in Amsterdam.

There is no clinical definition of “premium” cataract surgery. What it means is that medical insurance does not cover the extra cost of advanced lens or small incision surgical equipment beyond the “standard” monofocal solution.

By that logic, no insurance at all would make every IOL a “premium” IOL, argued Dr Mehta, surgical chief and director of the Mehta International Eye Institute, Mumbai, India.

The term is misleading for patients, he said. “The patient must believe that doing better surgery, utilising more advanced lenses and techniques, is rational surgery and not premium surgery.”

Go for the best

But it’s a challenge helping patients accept the fact that if they want good, stable vision, with no aberrations, they should go for the best lens available.

“What we have to do is let the patient see the premium IOL as a necessity. Explain the three functional ranges of vision. A standard IOL will allow patients to see one out of the three ranges, but a premium IOL may allow them to have all three,” Dr Mehta suggested.

For the patient to believe, you must believe yourself. To help your patients you must believe in the superiority of the technology and in your ability to deliver it, Dr Mehta said.

That goes for staff, too. From the first visit to the optometrist to the OR team, everyone should understand everything about IOLs and be able to communicate their advantages to patients.

Regardless of how great premium IOLs are, problems arise, Dr Mehta said. “The higher the price of the lens, the greater the expectations.”

Be wary of patients with unrealistic expectations, stress that vision will improve over time, and set realistic expectations, Dr Mehta said. “Explain that post-op visual aberrations may occur and glasses may be needed for some activities. But stress the positives of functional vision all day as opposed to the problems driving an hour at night. Time is the best investment. Under promise and over deliver,” he advised.

But realise that the unhappy patient is inevitable. Social networks are a big outlet for discontent. So turn it around by encouraging happy patients to tweet and Facebook their satisfaction, Dr Mehta suggested.

Most of all, help patients believe they are premium and their eyes deserve the most premium vision
you can give, Dr Mehta said. “It’s not premium vision, its necessary vision.”

Keiki R Mehta:
drkeiki@mehtaeyeinstitute.com