How often have you heard the questions, "Doctor, would you have this procedure yourself?" or "Would you perform this same procedure on a family member?" Many patients gain confidence in the procedures we offer when they know that we, as surgeons, have confidence in them. Of course experience counts heavily in this equation—patients are reassured to hear that we have performed hundreds or thousands of the same procedure they will undergo. However, another large boost in confidence comes if the patient knows the surgeon has put enough faith in a procedure to undergo it himself.
This issue features an entertaining array of articles written by surgeons undergoing laser- or lens-based refractive surgery. I am sure that, like myself, you will find the rationales behind the choice of procedures, from LASIK to lens exchange and phakic implants to enhancements, intriguing. There is no doubt that these surgeons have confidence in the procedures and enough assurance to subject themselves to the operation. This must be a confidence booster for patients and, although mentioned only briefly, it would be great to learn more about how each surgeon-turned-patient changed in terms of how they relate to patients after undergoing the procedure. The perspective of the surgeon-patient is interesting. Of course he has a lot in common with regular patients, but the major difference is the surgeon-patient's detailed knowledge of what might be taking place during surgery, as well as what might be going wrong.
As I often tell my patients, we are living in good times for eye surgery, partially because of technology as well as the variety of alternatives available to truly customize the choice to suit their needs. The optical quality of phakic implants is amazing; something must be said for preserving corneal optics. These IOLs provide great vision, and we are not even eliminating higher-order aberrations. In my personal experience, the majority of my patients gain a line or two of vision. (Their unaided postoperative vision is better than their best corrected preoperative vision.)
Laser vision correction with all the added options seems to be the favorite choice for most ophthalmologists. For instance, Massimo Gualdi, MD, writes about his experience undergoing iLASIK (Abbott Medical Optics Inc., Santa Ana, California). But those moving into the presbyopic age group have selected lens exchange and provide the rationale for doing so. The inventor of Crystalens (Bausch & Lomb, Rochester, New York), J. Stuart Cumming, MD, FACS, FRCOphth, naturally chose his own device, and a frequent user of the AcrySof Restor (Alcon Laboratories, Inc., Fort Worth, Texas), Tanneguy Raffray, MD, selected this option for himself. Other surgeons have ventured into different areas of refractive correction, such as Pait Teesalu, MD, PhD, who underwent laser blended vision, and Sabong Srivannaboon, MD, who underwent a topography-guided ablation.
I have not yet taken the plunge of undergoing refractive correction; however, in this issue, my colleague Saj Khan MB, BS, FRCSEd(Ophth) reports on his LASIK operation, which I performed. Perhaps someday I will be on the opposite side of the operating table, but for now I will stick to being the surgeon. Do I think this affects my ability to relate to my patients? Not really. I still have many years of experience to share with them. But I do respect my colleagues who have undergone lens- or laser-based refractive surgery. They have a unique opportunity to share their firsthand experience with patients.
It is reassuring that surgeons and doctors are undergoing highly elective surgical procedures to obtain freedom from optical crutches. As is clear from the articles in this cover focus, there is a common thread among them all: They are optimistic by nature and, most of all, believers in the technologies they offer to patients. We hope you enjoy this issue and perhaps consider undergoing refractive surgery yourself.