Refractive cataract surgery: office systems to improve results.

As we approach the second millennium, state-of-the-art cataract surgery means not only improved corrected vision, but also the opportunity to create better uncorrected distance and near visual acuity for patients by taking advantage of new technology and techniques. Patient satisfaction will ultimately depend on our ability and success in effectively meeting the challenge to reduce the need for spectacles after cataract surgery. A systemic and coordinated effort by various members of the office staff and the surgeon to monitor the results of IOL calculations will enhance the overall success for good uncorrected distance and near acuity after IOL implantation. Newer IOL theoretic formulas, better A-scan biometers, and the use of more reproducible A-scan techniques, such as immersion, can help to achieve greater accuracy. Newer computer software programs now offer database options to help in tracking results after surgery. As we carefully monitor postoperative results and troubleshoot those eyes that do not fall into the expected spherical target refraction after surgery, our IOL power accuracy improves and our patient's desire for less spectacle dependency will be satisfied.