Why “chair time” is essential when choosing an intraocular lens
Today we have a wide range of intraocular lenses (IOLs) available for cataract surgery and refractive lens exchange. These include:
- Monofocal lenses
- EDOF (Extended Depth of Focus) lenses
- Trifocal lenses
- Enhanced monofocal / monofocal plus lenses
Each option offers specific advantages and is suitable for a particular type of patient. Selecting the most appropriate IOL depends on two key factors:
- The anatomical and optical characteristics of the patient’s eye
- The patient’s lifestyle, visual habits and expectations
For this reason, chair time – the time the physician spends speaking with the patient – is essential.
1. Assessing the eye: increasingly precise diagnostic tests
Before choosing an IOL, we perform several diagnostic studies:
- High-precision biometry
- Corneal analysis (topography, aberrometry, keratometry)
- Macular and optic nerve evaluation (OCT)
- Tear film evaluation
- IOL power calculations and model selection based on optical profile
These tests indicate whether a given eye is or is not a good candidate for a certain lens type.
Not all eyes tolerate trifocal lenses equally well.
Not every patient benefits from an enhanced monofocal.
And some optical profiles work exceptionally well with EDOF lenses.
2. Talking to the patient: understanding real visual needs
Equally important is the conversation with the patient. During this time we analyse:
- Daily visual activities
- Reading habits
- Night-time driving
- Screen use
- Expectations regarding spectacle independence
- Sensitivity to halos, glare or contrast reduction
For example:
- A patient who rarely reads and is active outdoors or drives at night often benefits from lenses optimised for distance vision (monofocal, EDOF or enhanced monofocal).
- A patient who spends many hours reading or wants maximum independence from glasses is usually better suited for a trifocal lens, provided the eye is anatomically appropriate.
3. New-generation lenses: improving quality and reducing side effects
Recent advances in lens design have significantly improved visual outcomes:
- EDOF lenses now offer excellent distance and intermediate vision.
- Enhanced monofocal lenses provide increased depth of focus with minimal side effects.
- Trifocal lenses have reduced issues such as halos, glare and contrast sensitivity loss.
Thanks to these innovations, we are achieving:
- More predictable results
- Lower dissatisfaction rates
- Better overall visual quality
- Excellent outcomes even with lenses not designed specifically for near vision
Conclusion
Choosing the ideal IOL is not a quick decision. It requires:
- A thorough evaluation of the eye
- A detailed discussion to identify the patient’s real visual needs
- Time, precision and experience from the surgeon
This chair time is what allows us to personalise the choice, minimise dissatisfaction, and achieve the best possible visual quality for each patient.
