Clinical Pearls for Choosing the Right IOL with Sumitra Khandelwal, MD

Advancements in cataract surgery have significantly enhanced patient outcomes, with preoperative diagnostics playing a crucial role in optimizing intraocular lens (IOL) selection. Modern evaluations frequently include topography, optical coherence tomography (OCT) macula scans, and biometry to identify potential pathologies before surgery.

In an interview with HCPLive, Sumitra Khandelwal, MD, a professor of ophthalmology at the Cullen Eye Insitute at Baylor College of Medicine, and medical director for the Lions Eye Bank of Texas, discussed the importance of tailoring IOL selection to each patient’s lifestyle and visual priorities. Compared to previous generations, today’s cataract patients are more active and engaged in diverse visual tasks, requiring a more individualized approach.

Khandelwal recently presented a session titled “Pearls for Picking the Perfect IOL” at the Texas Ophthalmological Association (TOA) Annual Meeting in Houston, Texas.

Khandelwal stressed that patient education remains central to the decision-making process. While many arrive with preconceived notions—often influenced by internet research or anecdotal experiences—structured educational tools, including videos and questionnaires, help clarify realistic expectations. These questionnaires, administered before consultations, assess daily activities and willingness to invest in premium IOLs, guiding discussions toward the most suitable options.

Ultimately, Khandelwal indicated that the goal is shared decision-making between patient and provider. She pointed to no single lens as universally superior—each has distinct benefits and trade-offs. With a combination of advanced diagnostics, patient engagement, and personalized counseling, Khandelwal noted clinicians can ensure the best possible visual outcomes.

Khandelwal reports disclosures with Alcon, Bausch + Lomb, Dompe, Ocular Therapeutix, and others.

1. Khandelwal SS. Pearls for Picking the Perfect IOL. Presented at Texas Ophthalmological Association (TOA) Annual Meeting. Houston, Texas. March 21-22, 2025

2. Chandra S, Sivaprasad S, Ursell PG, et al. Recurring themes during cataract assessment and surgery. Eye (Lond). 2021;35(9):2482-2498. doi:10.1038/s41433-021-01548-4