Eyeworld

WINTER 2026 | EYEWORLD | 43 C Contact Chang: dceye@earthlink.net Miller: kmiller@ucla.edu Naseri: anaseri@Forsightv6.com Singh: kuldev.singh@stanford.edu Relevant disclosures Chang: None Miller: Alcon, BVI, Johnson & Johnson Vision Naseri: ForSight VISION6 Singh: None solution, especially those developing an accom- modating IOL. A lens that delivers uncorrected distance, intermediate, and near vision without dysphotopsias would create a new class of pre- mium lenses and transform the market." Surgeon support Dr. Naseri noted a 2024 paper that projects there will be a 30% shortage of ophthalmolo- gists in the U.S. by the year 2035. With cata- ract remaining the leading cause of treatable blindness globally, technologies that could be surgeon extenders are areas for investigation. "Some think robotic surgery could enable surgeons to provide care more efficiently or even operate from a location remote from the patient," Dr. Naseri said. "Remote robotic surgery faces real barriers, but the need per- sists, and we may soon have the technology to address this growing disparity." Dr. Chang also cited the surgeon shortage amid growing demand. "We are collectively achieving the best cataract surgical outcomes ever, but I worry that the status quo is not sustainable—financially, environmentally, and in terms of access to limited resources such as surgeons and operating rooms," Dr. Chang said. "Worldwide, I fear that cataract disability will exponentially rise if we don't develop a therapeutic approach that prevents or delays cataract formation. Individual surgeons need not fear. We'll be busier than we want to be, and we should encourage and support research that addresses this public health challenge. Because profitable products drive pharmaceutical invest- ment, perhaps industry can focus on delaying presbyopia. Any treatment that slows lens aging might delay both presbyopia and cataract. Because of the economic burden of this looming public health problem, this therapeutic objective warrants substantial governmental research funding." In addition to availability of those who can perform cataract surgery, Dr. Chang added that an affordable therapeutic approach to delay cat- aract progression "would do more to reduce the global burden of blindness than almost anything else that I can imagine." Sustainability "The rising domestic and global volume of cat- aract surgery amplifies the economic and envi- ronmental consequences of unnecessary surgical waste," Dr. Chang said, identifying sustainability as another area of unmet need. A lot of the waste comes from mandated single-use surgical supplies, which he said is based on "perceived rather than demonstrated safety concerns, compounded by regulatory and liability considerations." "More than 90% of ophthalmologists want more reusable options for surgical products, such as all-day phacoemulsification cassettes that remain in the machine for multiple cases," Dr. Chang continued. "We have clear evidence that reuse of selected supplies can substantially reduce both environmental impact and health- care costs without compromising patient safety. Because cataract surgery does not generate contaminated tissue or bodily fluids, it offers a unique opportunity to substantially reduce surgical waste." Dr. Chang pointed to EyeSustain, a global coalition of ophthalmologists and professional societies, which has been a "unified voice to urge industry and policymakers to prioritize more sustainable products and practices." Whether it's a presbyopia-correcting lens free of dysphotopsias, a therapy that delays cataract formation, or an OR that generates less waste, it's ambitious targets like these that the Innovation Priorities Task Force hopes to put in front of industry, regulators, and funders. In other words, it's time to shoot for the stars. "Those of us who perform cataract surgery owe a debt of gratitude to the many who have refined this procedure for the benefit of pa- tients," Dr. Naseri said. "We, too, can hope to continue advancing it for future generations of surgeons and patients."

• Cover