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Today's Practice | May 2014

The Ultimate Surgical Instrument

Cataract surgery remains the most common and, fortunately for us, the most effective and probably safest procedure in medicine. Many people consider landing on the moon as one of the greatest accomplishments in science, but I offer another: Giving people in their 60s, 70s, and 80s great—sometimes better-than-ever—visual function.

In our era, we have experienced continual and dramatic technological leaps in the safety, accuracy, and efficacy of cataract surgery. We now have a multitude of devices for diagnosing, measuring, calculating, preparing, and completing the procedure. This blossoming of technology and technique has materialized with the options of femtosecond laser-assisted procedures, a multitude of IOL options, and even intraoperative computer-assisted surgical guidance.

This month’s issue is devoted to the science and art of cataract surgery. A charismatic and experienced global group of cataract surgeons from Europe, Asia, and the United States share valuable technique pearls for seven key steps of the procedure. Roberto Bellucci, MD, and Simonetta Morselli, MD, from Italy; Khiun F. Tjia, MD, from the Netherlands; Abhay R. Vasavada, MS, FRCS, from India; Thomas F. Neuhann, MD, and Tobias H. Neuhann, MD, from Germany; Jorge L. Alio, MD, PhD, from Spain; Bjorn Johansson, MD, PhD, from Sweden; and David F. Chang, MD, from the United States, make up the ultimate dream team for the cataract operating room.

This year marks my 20th as a cataract surgeon, and, even with all my years of experience, I took away several valuable tips by reading through these articles. It is interesting how similar the surgical techniques of these masters of cataract surgery are, with the only minor differences being more personal preference than surgical protocol. I especially enjoyed learning how meticulous each surgeon is in his or her surgical approach and how the technique for each step of cataract surgery affects the next. I think this is a strong message in the age of reduced physician reimbursement fees globally, as it shows that we surgeons are working harder than ever.

I know I speak for all of us when I say that I feel blessed by having become an eye surgeon. I love being a front-line clinician— sorting through differential diagnoses at any hour of the day—just as much as I love being a surgeon—using high-tech gadgets and the latest surgical techniques and perfecting my skills for rapid decision-making.

I hope that you read this issue on refining one’s cataract surgical skillset thoroughly and consider sharing it with your ophthalmology residents, as surgeons of all experience levels can benefit from the tips and tricks these authors share.

The conclusion I have drawn from this excellent issue of CRST Europe is this: The ultimate surgical instrument for cataract surgery is the physician. By combining knowledge, experience, decisiveness, flexibility, proactive thinking, and the ability to handle mishaps effectively with sincerity, valor, and humanity, the physician holds in his or her hands all the tools needed to achieve the optimal postoperative result.

We are all providers of some of the most wonderful smiles after surgery, and we are fortunate enough to witness our patients enjoy the gift of regained vision. I hope that the pearls shared in these pages of CRST Europe will inspire you to continue on your quest to provide patients with the best care possible.

A. John Kanellopoulos, MD

Associate Chief Medical Editor