The importance of a cataract specialist on a cataract surgery

Most readers may wonder what is the big deal with cataract specialist. After all, all eye surgeons do cataract surgery, right?

Actually, all ophthalmologist trained in Spain have received a proper formation… Which means, theoretically, all of us are able to do a cataract surgery. True. That being said, once with improve our specialization in some other fields (i.e. squint eyes, lid surgery…), we tend to forget the basics. On the other hand, surgery is often left for younger surgeons when the years start to crawl on your back.

Besides that, most ophthalmologist do know how to perform a proper cataract surgery. So, we’re still left with uncertainty.

Cataract surgery

Choice of lenses

Cataract specialist use a broader range of lenses. A total of 6 lenses are commonly used. But cataract specialists often double or triple that number. I regularly use around 15 different lenses (lenses for complications not included).

More premium lenses

Dealing with a wider spectrum of lenses means that we can perform a clear crystal lens removal; in order to remove myopia (shortsightedness), hyperopia (farsightedness), astigmatism or presbyopia (aka old sight).

Moreover, facing this situation, we have more experience in telling when the result is going to be satisfactory or not. Every so often I tend not to risk a suboptimal result, going for the best result with the least risks… which leads into rejecting certain lens/patient combinations occasionally.

Fewer complications

Focusing the training in narrow fields allows the cataract specialist to obtain better results in the long term. Therefore, the severe complications rate (specially posterior capsule tears) is very limited. Recent European studies conducted among cataract specialists show a rate of 0.41. Currently, as you can see at the homepage, my rate is around 0.34% (November 2020).

Fewer surprises

Refractive surprises are the result of using the “recommended” lens and the results are not satisfactory… and we didn’t expect that.

Though we all do our best to get the best results by using several formulas, there are lots of formulas available and data to check. Traditional methods include 3 formulas and is not exempt of errors. However, newer and more sophisticated formulas are coming up, some even feature artificial intelligence. After all, perfection still doesn’t exist, and we may find a refractive surprise. Nowadays, the rate of refractive surprises has plummeted.

More surgery rooms available

We, cataract specialists, depending on the clinic, tend to have more hours available at the surgery room. So it’s easier for us to deal with a surgery on a shorter notice. Obviously, there is a wide difference between having the surgery room at your service once a month than once a week.

Don’t get me wrong, all ophthalmologists can perform a proper cataract surgery!! However, cataract specialist add value to the procedure.

  1. Manning, Sonia and Barry, Peter and Henry, Ype and Rosen, Paul and Stenevi, Ulf and Young, David and Lundström, Mats (2016Femtosecond laser-assisted cataract surgery versus standard phacoemulsification cataract surgery : study from the European Registry of Quality Outcomes for Cataract and Refractive Surgery. Journal of Cataract and Refractive Surgery, 42 (12). pp. 1779-1790. ISSN 0886-3350

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