While the number of candidates for cataract surgery continues to rise, the number of cataract surgeons is declining. Physicians who are willing to make a commitment to excellence in their practice and go that extra mile can succeed.
As the global population that is prone to developing cataracts continues to grow, ophthalmologist could be facing challenges as people live longer, increasing their odds for cataracts. Though this is a worldwide issue, in the United States, surgeons are performing about 4 million cataract surgeries each year.
It is estimated that there are about 30 million people worldwide who have cataracts of 20/400 or worse, and there are almost 250 million people who have cataracts between the range of 20/60 and 20/200. Cataracts are endemic.1,2
As technology improves, patients are more willing to undergo cataract surgery at an earlier stage as the reward of cataract surgery becomes much greater than the risk associated with it because it provides an opportunity to improve their quality of life.
Here are my thoughts on the ever-changing current landscape of cataract-refractive surgery. Patients’ growing confidence in cataract surgery is a byproduct of better technology. As technology has improved, it has made cataract surgery not only more efficacious but also safer. When I evaluate cataract surgery, I look at a procedure that has become extraordinarily successful, with much less risk and much greater reward.
Cataract surgery, for many patients, has become the “fountain of youth” because they can reverse the aging process and restore natural vision in a way that was not possible before. When I first started practicing in 1985, cataracts were the defining moment of old age, and postoperative quality of vision was significantly diminished. Therefore, it was common to wait until patients’ visual acuity was 20/70 before performing surgery.
Our goal was to remove the cataract and restore the patient’s vision with glasses. Now we can remove the cataract to improve their quality of vision and remove their refractive error— including hyperopia, myopia, and astigmatism. We can also improve their vision at near as well—with either monovision, extended-depth-of-focus (EDOF), or multifocal IOLs—to resolve refractive error and in some cases presbyopia as well.
Eric D. Donnenfeld, MD
E: [email protected]
Dr. Donnenfeld is a consultant to AcuFocus, Alcon Laboratories, Allergan, Aquesys, Bausch + Lomb, Beaver-Visitec International, Glaukos, Johnson & Johnson Vision, Novaliq, Ocular Therapeutix, Omeros, Pfi zer, and Shire Pharmaceuticals. He consults and has investment interests in Katena, Novabay Pharmaceuticals, PRN Pharmaceuticals, and RPS Diagnostics.
1. Market Scope estimate based on WHO 2014 Global Data on Vision Impairment.
2. Chandra S. U.S. Consumer Confidence Just Hit Its Highest Level in Almost 17 Years. https://www.bloomberg. com/news/articles/2017-10-31/u-sconsumer-confidence-index-rises-tohighest-level-since-2000 Accessed May 13, 2019.