Do you individualise choice of aspheric IOL as per patients' aberration..? And how do you do that? What to take into consideration?
You should go through
1. https://www.aao.org/eyenet/article/how-to-choose-aspheric-intraocular-lens (brilliang flowchart for IOL selection)
2. https://www.ncbi.nlm.nih.gov/m/pubmed/19244948/
(shows why aspheric lens will help the patient)
3. https://www.reviewofophthalmology.com/article/the-pluses-and-minuses-of-aspheric-iols
Somehow in order to optimise patient outcomes you need to use a multitude of techniques. Most important is accurate biometry, astigmatism if greater than 1D should be confirmed with 2 instruments ie a biometer and a corneal tomography machine. Then comes the IOL selection, aspheric in all, Toric if needed. Do wave front analysis if possible preoperatively. Most of the patients will be happy if you correct lower order aberrations only. In cases of premium IOLs. Do wavefront analysis both pre and post operatively. In case you have keratorefractive surgery available, offer ablation post op in case of residual aberrations. In the end it is something very patient specific. Documentation of astigmatism, visual acuity, CS and aberrations is vital for getting excellent results.
In order to perform an adequate aspheric selection we must do much more than presently id sone in most clinical environments. Please, tell the administrative/organizing people in your hospital environment that this is much more than a simple routine case determination of an intraocular lens!
IOL master to calculate IOL power, corneal topography, selection of
a spheric IOL type, and main incision on steep axis are important measures to decrease spherical aberrations
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