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Keeping up with the spectrum of surgical options
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The technology train never stops, and every year there are more surgical options to offer our patients. In fact, one of the big challenges of ophthalmology is keeping up with the new surgical techniques, products and devices that are introduced every year. This is the reason why I admire general ophthalmologists who find time to master so many different facets of eye care, from cataract surgery to refractive surgery, glaucoma to medical retina, strabismus to oculoplastics — they successfully do it all.
 IOL calculations in an eye with prior conductive keratoplasty can be challenging. |
I find it challenging to cover this full spectrum, and instead I've focused on just cataract and refractive surgery. This is hard to explain to my friends, who often ask, "The eye is about as big as a walnut — what do you mean you only specialize in part of the eye?" I specialize in just cataract and refractive surgery because it's what I find the most interesting and the most rewarding, and I'll spend my lifetime keeping up with the increasing spectrum of surgical options in this field alone.
Some of our surgical techniques have a steep learning curve, while others have a more gradual one, but the one thing in common is that figuring out the subtleties is what separates good surgery from excellent surgery. If you've seen someone like Michael Snyder, MD, or Robert Cionni, MD, operating on a challenging cataract case, it looks simple and elegant — but in reality, it is a major challenge. Even in cases of simpler procedures, achieving consistency and predictability is an art. This type of finesse takes time and experience, but the result is a procedure that is effective and reliable.
Sometimes the challenge is not the actual procedure itself, but rather the surgical planning before the procedure. Take, for example, this case of a patient with a history of successful conductive keratoplasty with consistent and symmetric spots on the cornea, where the cataract surgery is confounded by the difficulty in lens calculations and not the procedure itself.