5 Questions With Marie-José Tassignon, MD, PhD, FEBO

1. How did you first become involved with cataract and refractive surgery?
I first got involved approximately 15 years ago, when I became head of the department of ophthalmology at University Hospital Antwerp, in Belgium. I started out in vitreoretinal surgery, and I really liked it. In 1999, I was elected a board member of the European Society of Refractive and Cataract Surgeons (ESCRS), and I became more active in their programming. My work has progressed closely with the ESCRS programs.

2. You have served as department chair, professor, and/or a member of various organizations. Where you are currently focusing most of your energies?
There are so many techniques used nowadays, my major focus is trying to understand how a patient perceives the image they are looking at. We need to focus on quality of sight, since it is ultimately the most important part for the patient. In particular, we are now developing aspheric toric IOL with accommodating properties to offer full control over the quality of the image. This lens is called the bag-in-the-lens, which can be used in early childhood. Finding ways to ensure a high quality of vision should be our priority for patients.

3. As a member of the ESCRS, what challenges and goals do you envision for the organization's future?
As past president and also chair of the program committee, I think it is important for the organization to emphasize that ophthalmologists continue learning about physiological optics. It is absolutely imperative to better educate ophthalmologists in that field. In some European countries, fundamental sciences—like physics and optics—have been neglected in medical education. This part has to be taken over during training as resident in ophthalmology. Part of the mission of the ESCRS is to harmonize this part of education in Europe, so that the principals and technologies that we use everyday are fully understood. We need to understand the technology and its limits, and understand what instrument will help the ophthalmologist to achieve the best possible knowledge about patient's complaints and clinical results.

4. What do you see in the future for cataract surgery?
I think there will be a shift from refractive surgery to intraocular surgery for the correction of refractive errors since the lens is easier to replace than the cornea is to reshape. It will be possible in the future to calculate and measure the parameters of the ideal IOL, thanks to more precise technology. Obviously, the better the measurement, the more accurate vision will become. Like the telescopes that we use to look at the stars, that quality of vision should also be given to the patients. We need to focus on making the eye the best telescope ever. Combination of the corneal surgery with intraocular surgery will allow the ultimate finetuning provided the problem of accommodation has been solved.

We will continue to learn to what degree each technology is best to produce an optimal image quality. This will help to better define the limits and indications of each technology.

5. Of the pioneers of cataract and refractive surgery, who has had the most impact on your career?
Sometimes, the people who impact you the most are the ones who recognize you and believe in you. Having someone believe in you, that is what is important. For example, the first person who believed in me was Professor Jan Worst, from Groningen, Netherlands. After a presentation I was giving about Nd:YAG laser in premacular hemorrhage, he came on the stage, embraced me and said, "See, she proves clinically about what I have been saying for years in experimental work." Charles Kelman had also a very important impact on my career. After having listened carefully to my history of the bag-in-the-lens, he said "Patent that idea, it's brilliant". It is moments like that, that really have an impact on you.