Exposure to and Comfort with Toric and Presbyopia-Correcting Intraocular Lenses: A Survey of Ophthalmology Residents

To investigate exposure to and comfort with advanced technology intraocular lenses (ATIOLs) and ascertain residency program characteristics predictive of increased exposure and comfort.

A survey was created in REDCap and distributed to fourth-year (PGY-4) ophthalmology residents across the United States through the Association of University Professors in Ophthalmology (AUPO). The survey included questions on characteristics of ophthalmology residency training programs, understanding of preoperative counseling, intraoperative steps, and postoperative management pertinent to ATIOL implantation. Continuous and ordinal outcomes were analyzed using Kruskal Wallis or Wilcoxon Rank Sum Test and ordinal logistic regression, respectively.

There were 72 residents who completed the survey. Programs with multiple faculty offering ATIOLs provided greater opportunity for residents to observe preoperative counseling for presbyopia-correcting IOLs (OR 9.49 [1.70-52.8]; p=0.010) and practice preoperative toric IOL counseling themselves (OR 9.89 [1.70-57.6]; p=0.011). These residents also reported greater comfort with patient selection for presbyopia-correcting IOLs (OR 5.15 [1.05-25.3]; p=0.044). Programs with 10-25 faculty offered greater opportunity for residents to observe pre-op toric IOL (OR 4.98 [1.17-21.13]; p=0.03) and presbyopia-correcting IOL counseling (OR 8.98 [1.98-40.84]; p=0.004) compared to those with 0-10 faculty. Programs with industry-subsidized ATIOL programs had greater number of resident cataract cases as primary surgeon (Mean 184 vs. 137; p=0.014).

Incorporating exposure to ATIOLs into residency training curricula will equip trainees to be proficient with options that align with patients' expectations. This can be achieved by supporting clinician-educator faculty that use ATIOLs themselves and permitting industry representatives to interact with trainees.