Who will perform presbyopia-correcting IOL surgery?
I believe it is likely that presbyopia-correcting IOL surgery will probably segment into “haves” and “have-nots” in that a relatively small minority of surgeons will perform most of the volume. There is certainly a much greater hassle involved in educating and counseling these patients, optimizing biometry, and correcting postoperative ametropia. Many surgeons do not feel comfortable asking patients for thousands of extra dollars to upgrade their IOLs. Other ophthalmologists may serve communities where little disposable income is available for these lenses. Moreover, a number of surgeons lack the ability to perform the keratorefractive enhancements needed in a significant percentage of these cases. Still others will conclude that this added work simply overshadows the potential gain. On the other hand, declining reimbursement will spur some surgeons to embrace this technology. THE CHALLENGE OF DEALING WITH PRESBYOPIC PATIENTS Regardless of the IOL used, even perfectly executed surgery
