RESIDENT'S REVIEW

Patients Appreciate

Advanced Technology Lenses

By Katherine Whipple, MD

“My world has been changed because I can see so much clearer now.” These are the words every cataract surgeon wants to hear from a patient on postoperative day one, and this is the goal I've been aiming for since the day I decided to become an ophthalmic surgeon. However, learning cataract surgery is challenging. There are textbooks and journals to absorb, new techniques to learn and hours spent in a wetlab refining your surgical skills. Even when you feel like you're closing in on that “perfect surgery,” there is anxiety wondering if the patient will be as happy as you hope. After all, as I've been told countless times, “The perfect surgery doesn't always equal the perfect surgical result.”

Patient Satisfaction

In my experience, a patient's satisfaction with surgery depends on a combination of factors: surgical skill, understanding and managing expectations and having the acumen to implant the IOL best suited to the patient's needs. In that regard, advanced technology IOLs have become an essential part of providing patients with the best surgical outcomes. Working with these lenses early in my career has been a great benefit to me as a surgeon, but an even greater gain for my patients.

Advancing technology in IOLs is bringing cataract surgery to new heights, making the term cataract surgeon synonymous with refractive surgeon. Each new lens adds another level to the depth of our training. Who is a candidate for which lens? What additional preoperative information is needed? What contraindications exist for each of these lenses? When you're new to cataract surgery, the options can be confusing and overwhelming. It's easy to get comfortable with standard IOLs because they already make a great impact on a patient's vision. Is it worth pushing yourself to explore advanced technology lenses when you already have a surgery that works well?

The night after I implanted my first toric IOL, I lay awake anxious to know how my patient, a Vietnam War veteran, would do. The surgery had gone well. I'd already done more than 100 cataracts but I was restless, worrying about my patient. When I saw the grin on his face the next morning, I knew I'd made the right choice and one week later in a letter to me, he reassured me of that choice a second time.

“Dr. Whipple, I've worn glasses since I was 7 years old and now I don't have to. Because of you, I can see my family's faces without glasses clearly for the first time.”

Advanced Technology Benefits

Advanced technology IOLs, often referred to as premium IOLs, may seem like an extravagance. However, for a patient with corneal astigmatism, the toric lens is the best option to give him the best chance at optimal, spectacle-free visual acuity. Of course, there's a learning curve to trying anything new or different. There's also a level of uncertainty when pushing yourself beyond your comfort zone. However, it's during these uncomfortable experiences when I've learned the most and gained confidence as a surgeon.

Research continues to push us further with new techniques and tools, making cataract surgery more reproducible, faster and more precise than ever before. The modern era of cataract surgery—and medicine for that matter—is full of new treatment modalities that can significantly impact our patients' lives.

While safety is always of the utmost importance, as young surgeons, we must push our comfort levels to realize our full potential and do our best to restore the vision of our patients' youth. Becoming comfortable with standard and advanced technology IOLs is essential to providing the best treatment options to patients. As a physician, there's nothing more rewarding than knowing your work has vastly improved someone's quality of life. nMD

Dr. Whipple is Chief Resident in Ophthalmology at the University of California at San Diego. She graduated from New York Medical College in 2007 and is planning to start her fellowship in occuloplastics in July 2011 at the University of California at San Diego.