Eyeworld

DECEMBER 2021 | EYEWORLD | 3 by Eric Donnenfeld, MD Chief Medical Editor perspective on patient management. I promised myself I would never allow a patient to feel abandoned following any surgical procedure, whether I had performed the surgery or not. These are the patients I give my cellphone number to and try to do little things that let them know I care about their problem. These patients want to be heard, understood, and cared for; nothing should stand in the way of that. To me, compassion is fundamental to our commitment as surgeons. When I attend the ASCRS Annual Meeting and watch the amazing videos of my colleagues performing surgical gymnastics, I appreciate their dexterity and innovation, but more im- portantly, I recognize their willingness to help a patient who benefits from their expertise. This is just one of the things that makes ASCRS so special. With this issue of EyeWorld, we will all benefit from the wisdom and tips of managing complications in cataract, refractive, glaucoma, and corneal surgery. Topics discussed include dysphotopsias, iris prolapse, LASIK compli- cations, malignant glaucoma, tube exposure, bleb leaks, and graft detachment in DSAEK/ DMEK. These articles offer expert insight into the real-world management of these complica- tions that bring relief and sight preservation to patients. Doing what is best for our patients is always the most important concern, and learn- ing how to handle or who to refer these patients to is incredibly important as we approach the end of the tumultuous year 2021. I wish you all health, happiness, and the satisfaction of being an ophthalmologist and making a difference in your patients' lives. D espite having some of the most advanced technol- ogies available, sometimes com- plications happen. Although nothing compares to a com- pletely successful refractive procedure, resolving a complication can be one of the most rewarding moments in our profes- sional careers. Seeing a smile on a previously unhappy patient is a testimonial to the power of what we do as physicians in addition to being the ultimate practice builder. I'll share how the issue of complications impacted my perception of the refractive practice. The excimer laser was approved by the FDA in 1995, following an exhaustive and compre- hensive clinical trial. Since then, almost 20 million procedures have been performed in the U.S., and there have been hundreds of well-per- formed clinical trials that document the fact that LASIK is one of the safest and most effective procedures in all of medicine with outstanding accuracy and patient satisfaction. However, as with all procedures, complications do occur, although rarely. This is the background to one of the most significant events in my professional career. In 2008, the FDA, in response to 140 complaints, decided to hold a public hearing to assess the safety of LASIK and whether constraints should be placed on the procedure. Approximately 25 patients who had undergone LASIK and had experienced complications were scheduled to speak to the panel, while I was a representative of ASCRS speaking on the benefits of LASIK. I had expectations of unhappy individuals who were going to focus on their complication and how it had affected their vision and their lives. I could not have been more mistaken. The common theme was how they had experienced a problem with their procedure, and they sub- sequently felt abandoned by their surgeon who did not want to see them any longer, told them there was nothing they could do, or worse, told them they should be happy with their current vision (side note—never say this to a patient). This experience was one of the most educational events in my career, changing my Complications happen Seeing a smile on a previously unhappy patient is a testimonial to the power of what we do as physicians in addition to being the ultimate practice builder.

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