EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/87458
October 2012 EW NEWS & OPINION 23 both my parents were working. They didn't have enough money to send me to the university. I graduated from a university supported by the government. I got a scholarship. After 6 years, I graduated from the medical department and then I had to work in the rural area to treat people so I had to do anything, including internal medicine, anes- thesia, everything. It was my long- standing dream to be a specialist and treat blind people. I had to work in rural areas for 4 years first. Five years after graduation, I had a chance to study at Tokyo University to be an ophthalmic specialist. I very much appreciate having a chance to operate. EyeWorld: Why ophthalmology, specifically? Dr. Akahoshi: When I was in ele- mentary school I went to the hospi- tal and saw a lot of patients suffering from eye disease, and there was a fe- male doctor there working hard to treat those patients. I decided when I grew up I wanted to be a doctor to treat blind people. EyeWorld: You mentioned that you have been to 65 countries around the world. It sounds like teaching, as well as charity, is a passion of yours. Can you tell us why you feel it's important to teach? Dr. Akahoshi: The number of surger- ies I can perform a day may be 50, not 100, because there are compli- cated cases. Cataract is the number one cause of blindness in the world, and it is a curable disease. People become blind because they cannot be treated. It's necessary to teach doctors who can treat them. The number of patients I alone can treat may be small, but if I teach doctors, hundreds of doctors can operate the same way I do, and those doctors can treat millions of patients. The prechop is a very good technique, but a little bit tricky. There are some small tips and tricks. When I teach this technique to a doctor, I have a condition—I will teach you, but you should teach another doctor. If you agree, then I will teach you. I hope this method can make cataract sur- gery much more efficient, and many more patients in the world can be treated and saved from blindness due to cataracts. EyeWorld: Where do you see your future going? Will you continue at Mitsui? Dr. Akahoshi: Yes, I believe so, and I want to continue my charity work. I want to develop the quality of the surgery. I have been working 20 years to reduce incision size. Initially my incision size was 3.2 mm, but I developed special instruments and techniques to operate through a 1.8 mm incision. That was published 8 years ago, and since then all of my surgeries have been done through the 1.8 mm incision. EyeWorld: Socioeconomically speak- ing, you have operated on top lead- ers all the way down to the poorest of the poor. Dr. Akahoshi: The homeless, too. I do exactly the same procedure and implant exactly the same intraocular lens. No difference. Usually it would be hard to operate on more than 50 cases a day, but especially in Tokyo, patients come earlier. In Japan, to get a dri- ver's license, we need a visual acuity of 0.7, so people have to have good vision. The patients come much ear- lier than before, which means many easy cases to operate on. But in rural areas there are still very dense and complicated cases. I have had a chance to travel to developing coun- tries—Africa, the Middle East, and those countries; the patients never come to the hospital until they are almost blind. In those situations, the surgery is very difficult and compli- cated, takes time, and is risky. If I have a chance, I tell patients, "If you have any problems with vision, you should come and ask the doctor to see your eyes." If they have any problem with vision, they should be treated as soon as possible. EyeWorld: How rewarding is it to you as a physician to have people come in, maybe from a rural area, who are nearly blind from a cataract, and you are able to remove that cataract for them and change their lives? Dr. Akahoshi: All my surgeries are done with topical, so immediately after the surgery, the patients cry, "I can see!" It is impressive—a reason for me to continue and promote this hard work. Having the chance to see people smiling is wonderful. When patients come to the hospital, they are gloomy. After the surgery, those patients smile very big smiles. EyeWorld: What about your family? Do you see them? Dr. Akahoshi: I have a wife, Mie, and we travel to almost all the countries together. We share economy class tickets. It's a long flight. We travel together and we have a chance to see the world. She supports me. I finish my work at 11 p.m. at the hospital and then I have to make preparations for presentations. Eight years ago, when I developed the microcoaxial technique, I would get a lot of requests all over the world to show the surgery. No one believed that a 6 mm optic lens could im- plant through a 1.8 mm small inci- sion, but I developed an injector and technique to implant the lens. I needed to travel all over the world to show the technique. At that time, more than 50% of my days were spent abroad. I was always traveling, traveling, traveling. EyeWorld: Is there anything else that you think is important to dis- cuss? Dr. Akahoshi: Most of the time doc- tors think I operate so much that I should be an extremely rich doctor, but that is not how it is because I work in a charity hospital. I work not for money, but for the people, and I am doing my best to develop new techniques and new instru- ments. EW Contact information Akahoshi: +81 3 3862 9111, eye@phaco.jp Dr. Akahoshi performs live surgery in Bangladesh Source: Takayuki Akahoshi, M.D.