Refractive Lens Exchange Pearls from Dr. Uday Devgan

Uday Devgan, MD explores in detail his experience in refractive lens exchange (RLE) with OphthalmologyWeb retina editor David Goldman, MD. In private practice he does the gamut of refractive, lenticular and cataract procedures. He is also a clinical professor at UCLA where he trains residents on the use of both accommodating and multi-focal lenses. He describes many surgical caveats in presbyopic lens implants: Managing patent expectations in pre-operative consultations with younger vs. older patients. Management of astigmatism with LRIs in these patients. He describes the "bioptics" approach where the LASIK flap is cut contemporaneously with the lens exchange to allow for follow-up astigmatism correction via LASIK. Phaco pearls for non-cataract lenses including fluidics management and the use of viscoelastics in visco-mydriasis. "Epi-Sugar-caine" in the use treatment of Flowmax patients to counter floppy-iris syndrome. He also outlines the importance of patient education using your own practice's website.