EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/87458
World view Trial and suffering make for successful surgeons "S Bonnie An Henderson, M.D., cataract editor mooth seas do not make skillful sailors." That African proverb sums up this month's focus. Every surgeon will encounter difficult cases, unexpected situations, and unpredicted complications. Learning how to manage these challenging cases helps develop the skills of a surgeon. In fact, the ability to safely manage those situations is what differen- tiates a good surgeon from an outstanding one. In this issue, we asked expert cataract surgeons to recount some of their difficult cases and describe how they approached the cases. Lisa Arbisser, M.D., presents a difficult situation with a patient with mental disabilities who needed general anesthesia. In this situation, topics such as simultaneous bilateral surgery, primary posterior capsulotomies, and post-op care in a mentally disabled patient become important. She presents another case of a ruptured anterior capsule in a patient with a history of a pars plana vitrectomy. The status of the lens and capsules were not obvious until the case was started, and quick thinking was necessary to complete the case successfully. The use of femtosecond lasers in cataract surgery is one of the more controversial topics in cataract surgery today. The benefits of femtosec- ond laser-assisted cataract surgery are usually associated with repeatable and stable capsule openings in normal eyes. However, Rich Tipperman, M.D., presents a different scenario is which the femtosecond laser was very helpful for a safe outcome. Saras Ramanathan, M.D., describes a case of an eye with a short axial length. Many surgeons may approach a short eye similarly to the way they approach a normal length eye. However, as Dr. Ramanathan describes, there are many complications that can occur due to the limited working space. Steven G. Safran, M.D., presents a traumatic case in which a young man's iris was damaged in a fireworks explosion. Dr. Safran was faced with deciding whether to repair the iris or to implant a prosthesis. As a resident, I wondered how ophthalmologists could perform one type of surgery every week for their entire careers and not be bored. After I began performing my own cataract surgeries, I quickly realized that every surgery has its own special challenges. I have yet to see two cataract surgeries that are identical. Now when I struggle with a difficult case, I think of the famous quote from Helen Keller: "Character cannot be developed in ease and quiet. Only through experience of trial and suffering can the soul be strengthened, ambition inspired, and success achieved." Bonnie An Henderson, M.D., cataract editor Publisher Editorial Editor Jena Passut jena@eyeworld.org Managing Editor Stacy Majewicz stacy@eyeworld.org Production Graphic Designer Julio Guerrero julio@eyeworld.org Production Manager Cathy Stern cathy@eyeworld.org 703-383-5702 Production Assistant Daniela Galeano daniela@eyeworld.org Contributing Writers Vanessa Caceres Lakeland, Florida Michelle Dalton Reading, Pennsylvania Enette Ngoei Singapore Matt Young Malaysia Senior Contributing Writer Maxine Lipner Nyack, New York Classified Sales Cathy Stern cathy@eyeworld.org 703-383-5702 EyeWorld Special Projects and Events Jessica Donohoe jessica@eyeworld.org 703-591-2220 A SCR S The official publication of the American Society of Cataract & Refractive Surgery October 2012 Volume 17 • No. 10 PUBLISHING STAFF Advertising Sales Donald R. 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