Eyeworld

38 | EYEWORLD | SPRING 2024 ASCRS NEWS About the physician David F. Chang, MD Altos Eye Physicians Los Altos, California Contact Chang: dceye@earthlink.net the greatest unmet need in cataract surgery is higher global capacity, especially as populations around the world are aging. "Cataract is already the leading cause of global blindness because of growing backlogs in low- to middle-income countries where there are insufficient resourc- es and ophthalmologists to provide enough surgery," he said. Insufficient manpower, specifically the shortage of well-trained cataract surgeons, will soon become a problem even in higher income countries, Dr. Chang added. Another critical issue, he said, is sustain- ability. Because of the enormous waste gener- ated with surgical procedures (especially in the U.S.), as cataract surgical volumes increase, so will a disproportionately large contribution to landfills and carbon emissions from the highest volume operation in medicine. Dr. Chang's lecture will introduce the con- cept of "frugal innovation," which involves com- ing up with ways to deliver quality care, either less expensively or by using fewer resources. He will delve into specific case examples around the world where this has been implemented for cataract surgery. He will also touch on technology to poten- tially help automate cataract surgery to provide more people with quality cataract surgery. The ultimate frugal innovation in cataract surgery would be preventive medication, Dr. Chang said. While this isn't yet on the horizon, he said it should be a greater focus of research. The main message Dr. Chang aims to deliver with his lecture is, "to implore our most creative and talented ophthalmologists, re- searchers, engineers, companies, and leaders to think not only in terms of more advanced and expensive technology but also to be frugally innovative so that we can sustainably help the largest socioeconomic populations on the planet who have limited resources, funds, and access to ophthalmologists." Innovator's Lecture preview T his year, David F. Chang, MD, will deliver the Charles D. Kelman, MD, Innova- tor's Lecture during the ASCRS Annual Meeting. Dr. Chang has contributed, pioneered, and taught many surgical strategies for complex and complicated cataract cases. He co-identified intraoperative floppy iris syndrome and the need to manage it differently from other causes of small pupils. Dr. Chang has been a clinical investigator or advisory board member for numerous cataract surgical technologies, ranging from refractive IOLs and sustained-release drug delivery to automated and robotic surgical systems and an artificial capsular bag. He has been a proponent of IOL adjustability and was the first to implant the light-adjustable IOL in the U.S. Through his roles as past chief medical editor of EyeWorld and Cataract and Refractive Surgery Today, and past chair of the AAO Annu- al Meeting Program Committee, Dr. Chang has introduced innovative formats to cataract sur- gical education as well. Finally, he has champi- oned the need for innovative solutions to global cataract blindness and advancing sustainability in ophthalmology. Dr. Chang's lecture at ASCRS 2024 will highlight the importance of "frugal" innovation in cataract surgery to solve our greatest chal- lenges and unmet needs. "We tend to think of innovation in terms of new technology and inventions," Dr. Chang said. "ASCRS was founded 50 years ago to advance a controversial new technology, the intraocular lens, that was destined to become arguably the most impactful and widely implanted device in all of medicine." That, along with other inno- vations like phacoemulsification and LASIK, Dr. Chang continued, epitomize what we call "dis- ruptive innovation," in that they revolutionized the way that cataract and refractive error were treated. "Better and more advanced technolo- gies, such as an accommodating IOL, have been the never-ending quest for companies, biomedi- cal engineers, and ophthalmologists," he said. Although an accommodating IOL is often called the "holy grail," Dr. Chang said that Sumit "Sam" Garg, MD (right), presents William Link, PhD (left), with the award for the Charles D. Kelman, MD, Innovator's Lecture, which he delivered at the 2023 ASCRS Annual Meeting. Source: ASCRS

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