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There is room for improvement in all we do
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I began today with a long-term patient who recently underwent cataract surgery. A mere week out, he was smiling from ear to ear. When asked how he was doing, he simply stated: “Life is sweet.”
You see, as an 8-D myope with meibomian gland dysfunction-associated dry eye and a 2-decade history of diabetes, this patient has lived with some form of visual compromise for years. While he had dealt well with his visual limitations through those years, the tipping point came when he could no longer function comfortably at work … even with a 24” monitor. Now, he is cataract free and 20/20 without correction. For sure, life is sweet.
I have been practicing long enough to remember when cataract surgery was not so seamless – when visual recovery was both slow and uncertain and when patients questioned whether they had made the right decision. I remember a time in which incisions were not 2 mm but, rather, 12 mm. When extractions were extracapsular. And when postoperative pain and inflammation were the norm. But, perhaps most disturbingly, it was a time in which a patient endured induced astigmatism until we painstakingly removed their sutures at 6 to 8 weeks. Back then we conceded two certainties: life was not so sweet and we knew we needed to do better for our patients.
Michael D. DePaolis
Today, cataract surgery has become one of the true marvels of modern medicine for three reasons. First, the exponential growth of technology has translated into incredibly sophisticated phaco machines as well as a wide array of IOL platforms. Second, the skill set of today’s seasoned cataract surgeon assures patients of a procedure that is both brief and minimally traumatic. Third, our postoperative eye drop regimen almost always results in a clear and comfortable eye at the 1-day postoperative visit. With such strides, it begs the question: Is there any need for further advances in cataract surgery?
For sure, one could easily argue that we should leave cataract surgery alone. It is an extremely safe procedure, yielding impressive outcomes at an excellent cost-to-benefit ratio, resulting in extremely happy patients. Could life be any sweeter? Well, maybe. Suppose, for instance, we could achieve the same outcomes without requiring our patients to use multiple eye drops, multiple times daily, for weeks after surgery.
In our last issue of Primary Care Optometry News, we took a closer look at this concept in our article, “’Dropless’ cataract surgery enhances prophylaxis, patient satisfaction.” It was a great reminder that even something as refined as cataract surgery has room for improvement.
Of course, it is not just cataract surgery. There is room for improvement in virtually everything we do. What could be sweeter for a wet age-related macular degeneration patient who has regained vision with anti-VEGF therapy? Maybe fewer and less frequent injections. For a well-controlled glaucoma patient? Maybe delivering their medication via time-release punctal plugs in lieu of nightly eye drops. Or a young athlete whose contact lens wear is interrupted by severe seasonal allergies? Perhaps, a drug-eluting daily disposable contact lens.
Our commitment to you — our readers and colleagues — is to remain vigilant in our efforts to bring you contemporary and clinically relevant content — content that is relevant for what you do today as well as for what you will do tomorrow. My sense is if we can help make life sweeter for your patients, we will probably make it sweeter for you as well.