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Publication Exclusive: Cataract surgery moves beyond basics to reach a refractive mindset
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Welcome to another edition of CEDARS/ASPENS Debates. CEDARS/ASPENS is a joint society of cornea, cataract and refractive surgery specialists, here to discuss some of the latest hot topics in ophthalmology.
While the latest technology in surgical equipment, femtosecond lasers and IOLs has been grabbing the cataract surgery headlines, a critical aspect of cataract surgery may be underappreciated. This month, Neel R. Desai, MD, discusses the importance of optimizing the ocular surface before cataract surgery. We hope you enjoy the discussion.
Kenneth A. Beckman, MD, FACS
OSN CEDARS/ASPENS Debates Editor
Cataract surgery is not just cataract surgery anymore. Although a simplistic observation, it belies the complexity of patient interactions, lens selection, technologies, and physical and psychological factors that must be weighed carefully to produce successful outcomes in this era of refractive cataract surgery.
The time has come, I believe, for us as a community of ophthalmic surgeons to raise the bar and redefine “success” when it comes to cataract surgery and, further, for each individual surgeon to decide for himself or herself whether he or she is fully committed to achieving such outcomes in this new era. Is simple removal of a cataract and replacement with an IOL any longer an adequate definition of success? Are surgeons who still do not offer patients any form of astigmatism correction meeting an evolving and rightfully ascending standard of care? Is anatomic success really success if the patient does not see as well as he could have had he been offered instead a more customized treatment plan that heeded the patient’s refractive goals? I posit such questions not to cast derision but to stimulate the kind of introspection within the community of our peers that moves a profession collectively into the future to the benefit of our patients. It is the same introspection, I believe, that helped the standard of care in cataract surgery evolve from the days of intracapsular cataract surgery to modern phacoemulsification and ultimately to femtosecond laser-assisted cataract surgery, for instance. At some point in time, we collectively decided that the safety and benefits of phacoemulsification outweighed the interests of those who would cling to the status quo.
Click here to read the full publication exclusive, Cedars/Aspens Debates, published in Ocular Surgery News U.S. Edition, September 25, 2016.