Offering Value to Patients with Premium IOLs

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7 min read

In this episode of Interventional Mindset, Preeya K. Gupta, MD, and Gary Wörtz, MD, discuss patient communication around premium intraocular lenses (IOLs).

When it comes to improving vision quality for pseudophakic patients, integrating premium intraocular lenses (IOLs) into your practice is key to finding success with treatments.
While it might feel uncomfortable to initiate the conversation around any service that isn’t fully covered by insurance, the customizability of premium IOLs offers significant value to patients by tailoring the treatment to their individual needs.

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How do premium IOLs offer value to patients?

As an eyecare practitioner (ECP), it’s worth considering how you ascribe value to a treatment and then outline how to communicate this value to patients. Although similar, price and value are distinct, and to differentiate between the two, Dr. Wörtz highlighted the famous quote by Warren Buffet, “Price is what you pay and value is what you get.”
When discussing premium IOL recommendations with patients, part of the conversation is about making a value proposition to someone who wants to enhance their vision. When suggesting premium products to patients, keep in mind that not all patients will be good candidates for premium or upgraded treatments due to financial and/or refractive constraints. As with most things in life, a nuanced understanding of the situation is essential, and clinicians should be cognizant of the patient’s lifestyle when making these recommendations.
To convey the value of premium IOL correction to patients, it is helpful to contextualize the out-of-pocket cost of these technologies to investments they make in other aspects of their life. It’s also beneficial to compare these costs to those of other healthcare expenses, such as dental work or the management of systemic diseases. Explain to patients that investing in their vision is also an investment in their overall health and well-being. When looking at the quality of vision that refractive surgery can offer, the value proposition is much higher with an upgraded implant.

Pearls for presenting information on premium IOLs to patients

To facilitate patient communication, at Dr. Wörtz’s practice, the staff and clinicians provide patients with educational resources, such as brochures and videos, for added information on the procedures and IOLs. Patients are offered packets outlining associated adverse events (i.e., halos, glare, etc.), how the different parts of their range of vision will be impacted, and the possibility of postoperative enhancement. In addition, his practice utilizes surveys to gauge patient hobbies and lifestyle factors to get a general idea of the likelihood of their interest and their willingness for an upgrade to a premium product or procedure.
One of the educational resources on IOL selection used at the clinic where Dr. Wörtz practices is called the “Vision Target Form,” which features examples and pictures of how patients experience near, intermediate, and distance vision. For example, beneath distance vision are examples of a busy road from the driver’s perspective and a movie screen in a theater. The pictures help patients explore the three different ranges of vision, thereby pushing them to start thinking about how different IOLs might impact their vision.
Dr. Wörtz also mentioned that he has noticed that patients tend to have a higher chance of upgrading if there is a family member accompanying them. In the early stages of the COVID-19 pandemic, when patients had to come to the clinic alone, he found that patients would often feel guilty about spending money on themselves and would consequently opt for a standard monofocal IOL. Now that family members and loved ones can come back to these sessions with the patient, they can advocate for the patient and release them from a sense of guilt over spending money on their health.

Using your clinical expertise to explain treatment value

When counseling patients, remember that the treatment's value is not limited to which lens is chosen; it’s also affected by the patient’s quality of vision following implantation, and the latter is often the most important component to the patient.
To factor this in, Dr. Gupta recommends early on having the patient clearly state what their treatment goals are, that way the clinician can match their needs to the best-fitting IOL. By reiterating their goals and creating a concise connection between what vision they want and what lens or procedure is needed, the potential for miscommunication or confusion is minimized.
Additionally, Dr. Gupta emphasized that a recommendation made by a clinician is only as strong as their clinical experience and knowledge of that procedure or technology. To convert patients to premium products, genuinely believing and being excited in their ability to improve the patient’s vision is key. While premium IOLs may be labeled elective by insurance companies, they are not elective in the value that they can offer patients in correcting their vision.

Being an “IOL matchmaker”

One way to think of the ECP’s role in choosing an IOL for the patient is as a matchmaker. Similar to matchmaking, it is helpful to have a general understanding of the patient’s lifestyle when selecting an IOL. In essence, clinicians must use their clinical expertise to match a set of wants and needs from the patient with IOLs currently on the market and minimize as many potential tradeoffs as possible.
During this process, clinicians should try to put themselves in the position of the patient to understand what could be going through their mind. For example, a common concern related to vision for elderly patients is the loss of independence. About 90% of all information transmitted to the brain is visual,1,2 so for many elderly patients, their quality vision is a key factor in maintaining independence.
When talking to older patients, Dr. Wörtz often explains that with age, they will tend to rely more on their vision to process environmental information, so if remaining independent is a priority, investing in their vision to maintain independence is a logical step.

Conclusion

By factoring in these considerations during conversations with patients, clinicians can tailor both the treatment and communication to every patient’s individual needs.
The pearls outlined above provide relatively small steps clinicians can take that will positively impact their patients' quality of vision.
  1. Kosmyna N, Lindgren JT, Lécuyer A. Attending to Visual Stimuli versus Performing Visual Imagery as a Control Strategy for EEG-based Brain-Computer Interfaces. Sci Rep. 2018;8(1):13222. doi:10.1038/s41598-018-31472-9
  2. Potter MC, Wyble B, Hagmann CE, et al. Detecting meaning in RSVP at 13 ms per picture. Atten Percept Psychophys. 2014;76:270. doi: 10.3758/s13414-013-0605-z
Preeya K. Gupta, MD
About Preeya K. Gupta, MD

Dr. Gupta earned her medical degree at Northwestern University’s Feinberg School of Medicine in Chicago, and graduated with Alpha Omega Alpha honors. She fulfilled her residency in ophthalmology at Duke University Eye Center in Durham, North Carolina, where she earned the K. Alexander Dastgheib Surgical Excellence Award, and then completed a fellowship in Cornea and Refractive Surgery at Minnesota Eye Consultants in Minneapolis. She served on the faculty at Duke University Eye Center in Durham, North Carolina as a Tenured Associate Professor of Ophthalmology from 2011-2021.

Dr. Gupta has authored many articles in the peer-reviewed literature and serves as an invited reviewer to journals such as Ophthalmology, American Journal of Ophthalmology, and Journal of Refractive Surgery. She has also written several book chapters about corneal disease and ophthalmic surgery, as well as served as an editor of the well-known series, Curbside Consultation in Cataract Surgery. She also holds several editorial board positions.

Dr. Gupta serves as an elected member of the American Society of Cataract and Refractive Surgery (ASCRS) Refractive Surgery clinical committee, and is also is the Past-President of the Vanguard Ophthalmology Society. She gives presentations both nationally and internationally, and has been awarded the National Millennial Eye Outstanding Female in Ophthalmology Award, American Academy of Ophthalmology (AAO) Achievement Award, and selected to the Ophthalmologist Power List.

Preeya K. Gupta, MD
Gary Wörtz, MD
About Gary Wörtz, MD

Gary Wörtz, MD is a board-certified ophthalmologist from Lexington, KY specializing in cataract and refractive surgery.

Since completing his training in 2008, Dr. Wörtz has successfully performed thousands of cataract and laser procedures. He currently practices in Lexington at Commonwealth Eye Surgery. Dr. Wörtz became one of the first surgeons in Kentucky to perform laser refractive cataract surgery. He utilizes the latest technology both in and out of the operating room to help restore vision for cataract patients.

Dr. Wörtz enjoys innovation and teaching his techniques to others around the country. He has been a consulting speaker for Alcon, AMO, Bio-Tissue, TearLab, Carl Zeiss Meditech and Dialogue Medical. He has also been a principal investigator in multiple FDA pharmaceutical trials in the ophthalmic sector. He has given numerous lectures at both the American Academy of Ophthalmology and the American Society of Cataract and Refractive Surgeons annual meetings. He is also a frequent contributor to many trade journals such Cataract and Refractive Surgery Today, MillennialEye, Ophthalmology Times, and EyeWorld, and was recently named to the editorial board of Ocular Surgery News.


Gary Wörtz, MD
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