Mastering Refractive IOLs: The Art and Science

Abstract

Mastering Refractive IOLs: The Art and Science David F. Chang, ed., Thorofare, NJ: Slack Inc.; 2008. $204.95.FigureIn 1949, the first U.S. intraocular lens (IOL) implant procedure was reported at the Wills Eye Hospital in Philadelphia.1 Since then, the field of cataract surgery has witnessed profound growth as advances in IOL designs and surgical techniques have rendered implantation easier while minimizing side effects. With 40 million Americans becoming older than 65 years in the year 2010, there is an ever increasing demand for improved functional vision and surgery using IOLs specifically targeted at dealing with presbyopia. What we think of as the traditional “cataract surgery” now more appropriately falls within the realm of “refractive surgery.” Students of vision and visual technologies will find an extensive new material in “Mastering Refractive IOLs: The Art and Science,” a book that provides a comprehensive and critical overview of these new developments. David Chang has brought together a wide-ranging group who assess and offer their perspective on a myriad of topics including IOL selection, presurgical assessment, surgical technique, and complications. Acknowledging that much controversy exists over IOL strategies and management of postoperative complications, the authors offer practical tips and pearls in many aspects of the surgical procedure. The chapters on “Mastering Refractive IOLs” also proffer insights into exciting new technologies and techniques that are under development. Within these covers are chapters devoted to biometry and lens power calculations in eyes that have had prior keratorefractive surgery and a refreshing insight into specific IOL lenses from practitioners who themselves had implants. Advice on the future trends of this market and management topics, such as marketing consideration for the refractive IOL patient, are among other areas covered. Also included is a useful appendix, which offers patient questionnaire templates, a model preconsultation information booklet, and informed consent documents—invaluable resources to clinicians who seek to provide high-quality cataract and refractive surgical care. Because of its size and density, the book succeeds mainly as a reference guide or as text for selective topical reading. IOL technologies are in rapid flux, and with 14 sections and 200 chapters that address essential advances in the field of refractive IOLs, this book provides the reader with a broad overview and an extensive detail about the clinical care of the refractive IOL patient. It features detailed illustrations to aid the surgeon with all conceivable aspects of surgical techniques. Numerous high-quality color photographs and full-color artwork complement the text and additionally help with the understanding of the topics. Chang has designed the book to have multiple experts cover a specific topic, with generally a couple of (but in one case six) chapters devoted to the same subject. By having several clinicians from different backgrounds address common topics independently, “Mastering Refractive IOLs” invites the reader to compare different IOL management strategies. Although some difference of opinion is inevitable with new technologies, the lack of consensus within these topics may frustrate readers new to the subject matter. Among the premium lens choices (aspheric, toric, multifocal, and accommodating IOLs), each lens offers distinct benefits, and the vision specialists chosen to cover them offer tips and rationale for their strategies. However, the book suffers from much repetition and relies on the reader to filter through the many surgical pearls offered to decide on what would be best for their practice. Although, “Mastering Refractive IOLs” mainly targets cataract surgeons, it may serve as a useful reference to others with an interest in this field. Given the sparse literature on refractive IOLs, Dr. Chang has successfully put together a comprehensive, widely ranging resource of the most current information available on the subject. Kristen Fry Cornea and Laser Eye Institute UMDNJ-New Jersey Medical School Teaneck, New Jersey