Eyeworld

92 | EYEWORLD | JUNE 2022 by Liz Hillman Editorial Co-Director About the physicians Constance Okeke, MD Assistant Professor of Ophthalmology Eastern Virginia Medical School Norfolk, Virginia Nathan Radcliffe, MD New York Ophthalmology New York Eye Surgery Center New York, New York G UCOMA H aving a growth mindset throughout one's career is important, according to Nathan Radcliffe, MD. But there is discernment and a process that affects when to learn new techniques and adopt new technologies. Dr. Radcliffe said when he finished his glaucoma fellowship, he hadn't performed MIGS at all. Now, he's adopted all of the newer MIGS options. "The focus of my career surgically is some- thing that I wasn't trained to do in fellowship. This highlights the value of taking a perpetual look at your career, and I think that if 3 months have gone by and I'm in the operating room and haven't found something new to incorpo- rate, changed a technique, talked to a colleague about a better way to do things, I'm slipping behind," Dr. Radcliffe said. "We're fortunate to have change and evolution in our treatments. That's going to help our field and our patients in the long run. I think having a growth mindset approach to adopting new glaucoma procedures is incredibly valuable." Dr. Radcliffe and Constance Okeke, MD, spoke with EyeWorld about their process and considerations when it comes to bringing in new options that could enhance patient care in their glaucoma practices. EyeWorld: How do you know when to adopt a new technology or technique? What is the onboarding process like? Dr. Radcliffe: I think a lot of the decisions in when to adopt new technology vary from doctor to doctor, and it's a disposition that may relate more to our personality characteristics. Some are early adopters and have an itch that needs to be scratched in making sure they've tried all the available options, and there are some who vary only a little from their residency training throughout their career. It has to do with your attitude toward rocking the boat and trying new things. In glaucoma, I think there is a general feel- ing that we need innovation because we are so keenly aware that our current treatment options are never quite sufficient. They get better every year, they get safer every year, but we know we haven't cured the disease yet, so we want to keep trying new things. For some doctors, the recommendation of a colleague will be very important. … Relationships can go a long way here as well. I think there is a true value that device representatives from the companies provide because they aren't just there to push products, they help with education, they have training labs, there are tangible benefits that these representatives bring. The other thing is they get to spend time in the operating room with surgeons and they often have a lot of expe- rience to share. So talking with representatives about complications, how to handle problems, even in some cases how to handle billing and coding, all of these conversations are beneficial. Dr. Okeke: When it comes to adopting a new glaucoma treatment, sometimes I may be in- volved with clinical trials and have the ability to get some experience with it, which can make it easier to adopt when it comes out commercially. There are instances where I may want to adopt a new technology earlier, but I might be stalled due to poor insurance coverage or limitations Insights on adopting new technologies The Durysta implant is inserted into the inferior anterior chamber with a cotton tip used for stabilization.

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