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June 1996

The Surgeon's Dilemma

Author Affiliations

West Hills, Calif

Arch Ophthalmol. 1996;114(6):774-775. doi:10.1001/archopht.1996.01100130766036

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In his editorial, Dr O'Day1 calls our attention to what may be a "surgical industrial complex," consisting of equipment manufacturers, publishers of glossy tabloids, and surgeons who have a high volume of cataract surgery and work outside the hospital environment. He suggests that this body is responsible for an ever developing arena of surgical devices and methods concerned with cataract surgery. He cautions us to recognize that the frequent technological changes in smallincision cataract surgery may be costly and that these new methods have not been established by evidence in the refereed literature as truly superior to prior techniques. He asserts that the routine use of phacoemulsification may be neither advantageous nor cost-effective and refers us to an article in the same issue of the Archives by Schein and coworkers2 that reports the surgical preferences of randomly surveyed members of the American Academy of Ophthalmology regarding cataract surgery

O'Day DM.  The surgeon's dilemma . Arch Ophthalmol . 1995;113:1105-1106.Article
Schein OD, Bass EB, Sharkey P, et al.  Cataract surgical techniques: preferences and underlying beliefs . Arch Ophthalmol . 1995;113:1108-1112.Article
Cataract Management Guideline Panel. Cataract in Adults: Management of Functional Impairment . Rockville, Md: Dept of Health and Human Services, Public Health Service, Agency for Health Care Policy and Research; 1993;2. Clinical Practice Guideline No. 4, AHCPR publication 93-0542.
Schein OD, Steinberg EP, Javitt JC, et al.  Variation in cataract surgery practice and clinical outcomes . Ophthalmology . 1994;101:1142-1152.Article
Hayashi K, Hideyuki H, Nakao F, Hayashi F.  The correlation between incision size and corneal shape changes in sutureless cataract surgery . Ophthalmology . 1995;102:550-556.Article
Steinert RF, Brint SF, White SM, Fine IH.  Astigmatism after small incision cataract surgery . J Cataract Refract Surg . 1991;98:417-424.