Clubhouse: The modern-day Cheers bar for premium surgeons
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Cheers, the American sitcom that aired from 1982 to 1993, was set in Cheers Beacon Hill bar in Boston, where a group of locals met to drink, relax and socialize. The theme song “Where Everybody Knows Your Name” truly represented the show.
In this era of social media, how can Cheers have any relevance? In the pre-COVID era, most of the pearls for my practice — surgical, medical, administrative, efficiency strategies — were learned in hallway chats and small gatherings at most eye meetings, large or small. Since the pandemic began, much has changed on how we obtain our pearl-like information from each other as premium surgeons.
A recent popular approach has been Clubhouse, which began in 2020, an audio-only chat app where there are “rooms” of members talking about subjects. Users enter a room as an audience member but can virtually raise their hand to ask a moderator to become a speaker. Alternatively, its users can host their own rooms. The only downside in my opinion with Clubhouse is its invite-only approach, and despite this air of exclusivity most popular with certain celebrities, Clubhouse does have an excellent way to chat, no different than we do at our own local Cheers bars and hallways and lobbies of hotels and convention centers with our premium colleagues.
Clubhouse room: Premium IOLs
Part of the mission statement at my Jacksoneye practice is the ability to give patients a premium experience with premium IOLs: “Seeing beyond your imagination.” I now invite all my premium channel colleagues to the first Clubhouse column piece to see how we deliver the variety of premium IOL technologies now available.
We conducted a retrospective study looking at the best objective target when using the Symfony or Symfony toric IOL (Johnson & Johnson Vision). When looking at uncorrected distance, intermediate and near visual acuities in both eyes across all ranges of vision, we found that the best target manifest refraction spherical equivalent was –0.07 ± 0.14 D for the dominant eye and –0.21 ± 0.24 D for the nondominant eye. This extended depth of focus IOL technology has been excellent in my hands when obtaining a plano or near-plano result in the dominant eye and –0.25 D sphere outcome in the nondominant eye with minimal spider halo side effects.
When patients are more concerned with their near vision capability postoperatively and have no other ocular comorbidity, I look to use the non-apodized diffractive trifocal PanOptix IOL (Alcon), which sends energy to three near focal points (40 cm, 60 cm and 80 cm) as well as distance regardless of pupil size. The goal in my hands with this IOL is a plano target in each eye and/or first click minus in the nondominant eye.
The non-diffractive newest addition to my premium IOL armamentarium has been the Vivity and Vivity toric IOL (Alcon), which mimics the side effect profile of a monofocal IOL, especially with night vision disturbances, but provides a wide range of uncorrected vision capability as low as J2 at near in many of my patients, especially when you target the dominant eye at –0.25 sphere and the nondominant eye at –0.75 sphere. This technology has expanded my reach of premium IOL conversions, as it has been successful even in patients with mild epiretinal membranes or other mild macular pathology.
The Light Adjustable Lens (RxSight) has brought insane 20/10 to 20/15 UDVA outcomes for distance due to its adjustability postoperatively, being able to correct up to 2.5 D of astigmatism. The inconvenience of wearing the UV protective glasses postoperatively has only brought convenience of vision to all my patients so far with this technology. I also started using this technology to provide a blended vision option and look forward to the EDOF option in the near future.
Lastly, Eyhance (Johnson & Johnson Vision) in its non-toric and toric option will most likely be the monofocal toric of choice for many of my premium colleagues, as it brings the toric correction option with “benefits” of intermediate vision while preserving the side effect profile of a monofocal IOL. The upside of this newest addition is the “surprise” vision effect we give our patients for added near vision capability without having to “guarantee” a refractive outcome, as this is not a true billable premium option.
Nevertheless, whether you are from the Cheers era or the Clubhouse social media era, I look forward to more chats on anything premium with all my premium colleagues and especially getting back to those live hallway chats at meetings in the near future. Stay safe and keep your patients “seeing beyond [their] imagination.”
- Reference:
- Jackson MA, et al. Clin Ophthalmol. 2020;doi:10.2147/OPTH.S237457.
- For more information:
- Mitchell A. Jackson, MD, can be reached at Jacksoneye, 300 N. Milwaukee Ave., Suite L, Lake Villa, IL 60046; email: mjlaserdoc@msn.com.
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