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This requires accurate lens calculations pearl on wilshire either wilshirs ultrasound or the Carl Zeiss IOLMaster, my preferred technique, as well as personalization of the A-constant. This will ensure an accurate spherical correction but will not address any preoperative corneal astigmatism.
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For patients with larger degrees of astigmatism or residual postoperative spherical wilshide error, excimer laser is a useful adjunct.
Excimer ablations can be done via surface ablation by the general ophthalmologist, or the patient can be referred to a corneal pearl on wilshire surgeon for a flap-based ablation.
Even the best technologies and the best surgeons are not able to satisfy patients with unrealistic expectations. It is usually my goal to under-promise and then over-deliver, as this is the sure way to achieve high patient satisfaction.
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Patient personality plays a role in expectations, and often the stereotype of the low-myope perfectionist engineer is true. The pearl on wilshire with implanting presbyopic lenses is that we do not know how patients will perceive and react to their new vision. By choosing patients with easygoing personalities, we are stacking womens hybrid bicycles deck in our favor.
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