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Satisfactory surgical result redefined
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A respected colleague of mine who teaches in a nearby county hospital likes to say, “A successful day in surgery is one where every patient gets a PC IOL, you get to eat lunch and your feet stay dry.”
In post-residency practice, we have a little higher standard. But until recently, surgery was considered satisfactory just because it was free of complications. Increasingly, patients expect and deserve better results as we see a greater adoption by surgeons of new technologies and greater awareness of astigmatism correction.
The cover story on this issue of Ocular Surgery News about astigmatism correction is well-timed, and it is my belief that every surgeon should at least consider how much residual astigmatism each patient will have following surgery. This can lead to an appropriate discussion of correction options for patients who are interested in astigmatism correction and are good candidates for it.
There is a wide spectrum of surgeons with differing interests in performing simultaneous refractive surgery for their cataract patients, and there are different levels of comfort with these additional procedures. However, we should be aware that patients now measure their result of surgery not based on the absence of complications, but on how well they see and how soon.
Virtually everyone of cataract age has some friends who have been through the procedure, and they hear “it was a piece of cake,” “it was painless” or “vision was nearly perfect the next day.”
That’s a high standard for us surgeons to live up to. No matter how hard we try, some patients will have limited vision, some will have pain and some will have complications. Nevertheless, correcting astigmatism – be it with astigmatic keratotomy, a toric lens or simply placing the operative incision along the optimal axis – is a value-added service that many patients desire and deserve.
View Dr. Hovanesian’s video on Three Steps to Correcting Astigmatism in Cataract Surgery at www.bettereyesurgery.com.