How has ophthalmology changed in 2016?

As the end of the year approaches, we wanted to take a look back at the predictions our Editorial Advisory Board members made for 2016 and see how far ophthalmology has come in the last 12 months. To read their original predictions, click here.

A special thanks goes out once again to Peter J. McDonnell, MD, Randall Olson, MD, Andrew G. Lee, MD, Sharon Fekrat, MD, and Robert K. Maloney, MD, for sharing their insights.

Keep a lookout for their thoughts about 2017!

"Where do you see the most growth in the field of ophthalmology?"

Dr. McDonnell anticipated the specialty as a whole would need to adapt to provide more efficient care, to more people, at lower costs.

He wrote about the increasing pressures put on ophthalmologists in a recent editorial, “Ten-day workweek for ophthalmologists.” In addition, some experts weighed in about how to best prevent ophthalmic burnout.

Dr. Olson anticipated the approval of the Tecnis Symfony IOL (Abbott) and Light Adjustable Lens IOL (Calhoun Vision), which he said would be game changers in the refractive premium IOL market. Indeed, the big IOL news of the year was approval of the Symfony IOL as the first extended-depth-of-focus IOL.

Molecular genetics, small molecules as drug delivery targets, and nanotechnology were the areas Dr. Lee anticipated major advances in during the year. This year, positive results were observed from a phase I trial of voretigene neparvovec to treat a gene mutation in patients with retinal dystrophy.

(Cont.) "Where do you see the most growth in the field of ophthalmology?"

Sharon Fekrat, MD, predicted the most growth in the field would be in imaging technology. From portable devices for meibomian gland imaging, to aqueous angiography, as well as 3-D heads up retinal imaging and a dual-modality OCT and OCTA imaging system, advances were undeniably heavy in the technology space.

Dr. Maloney saw major advancements coming for femtosecond laser cataract surgery. “Those of us who do this regularly feel we are stepping back into olden times when we do standard cataract surgery,” he said. Many reports over the past year continued to shed light on the improved surgical outcomes from FLACS.

"What advances are you anticipating in the coming year?"

Dr. McDonnell greatly anticipated seeing how the first approved corneal inlay (KAMRA inlay, AcuFocus) would fare in the marketplace. Since then, another inlay (Raindrop Near Vision Inlay, ReVision Optics) has also been capturing surgeons’ attention.

In addition, Dr. McDonnell's hope that corneal crosslinking (CXL) would make its entrance into the U.S. market finally came true this year. Since its approval, CXL has shown to be a safe, effective procedure for treatment of keratoconus and corneal ectasia. Various methods of the CXL procedure, such as photorefractive intrastromal crosslinking (PiXL), epi-on CXL, and accelerated CXL, have also gained in popularity and use in the United States.

Dr. Olson could not wait to have new options for dry eye products. You may have been living under a rock if you did not hear Shire’s new dry eye drug, Xiidra, was approved by the FDA this year for the treatment of the signs and symptoms of dry eye disease. You can read about the results of the OPUS-3 study here.

(Cont.) "What advances are you anticipating in the coming year?"

Dr. Lee expected the Argus II Retinal Prosthesis System (Second Sight Medical Products) to become a major player in 2016. Earlier this fall, the company released the device’s 5-year safety and performance results, which were overwhelmingly positive.

Key advances Dr. Fekrat expected included tele-ophthalmology and self-diagnosis with apps. A recent editorial described the ironic experience an ophthalmologist had with tele-medicine. In terms of new apps, several ophthalmologists weighed in about what apps make their daily work more efficient.

"Where do you think the ophthalmic community will stand a year from now?"

“The number of brilliant, incredibly qualified medical students seeking ophthalmology residencies in the United States today far exceeds the number of available training slots," Dr. McDonnell said in late 2015. "This allows us to be extremely selective. So we have a pipeline of the best and brightest pursuing careers in our specialty, and this obviously augurs well for the continued vibrancy and success of our field.”

Josh Mali, MD, an OT blogger, explained the top 5 things interviewers look for in residency candidates, and the top 5 things candidates should look for in a residency.

"Where do you think the ophthalmic community will stand a year from now?"

Dr. Maloney thought by the end of 2016, ophthalmologists would be using fewer post-op topical drops. Earlier this year we featured some updates about dropless cataract surgery outcomes and its potential financial implications should it become a standard-of-care.

"What do you see as the major hurdles we will be confronting?"

The consensus among our Editorial Advisory Board members was decreasing reimbursements would pose a challenge for ophthalmologists in 2016. Most ophthalmologists would probably agree this was in fact a struggle. However, ophthalmology as a specialty is very adaptive, and as Dr. Maloney optimistically stated, “we’ll soldier through.” 

More: How payer perspective guides reimbursement

Related: Value-Based Payment program presents potential ramifications