What has been the greatest challenge of your career?
We all face various challenges at different stages in our career. My wife often reminds me that my greatest challenge is to stop being a perfectionist 100% of time.
What do you consider to be the most exciting surgical development?
The evolution of refractive cataract surgery has had a tremendous impact on my practice. So many aspects of my interactions with patients have changed and advanced. More choices for patients, tighter refractive outcomes, and incredible capabilities come from femtosecond lasers, advanced ultrasound phacoemulsification, and the latest generation of IOLs. At the same time, patients (and surgeons) expect greater outcomes. Finetuning results with corneal treatments (laser or incisional) or performing an IOL exchange is a part of this process. Working comfortably in this environment takes experience, patience, and perseverance.
How do you anticipate prosthetic devices designed to assist complicated or unusual cataract surgeries will evolve over the next 5 years?
I am confident we will have more choices and more capabilities than we do now. We are only limited by our imagination, the cost of the devices, and the FDA's approval. We still need a better solution for zonulopathy, and scleral fixation will become more reliable. Iris tissue prostheses have progressed outside the United States and, I hope, will encourage the approval of a device by the FDA in the United States.
How do your aptitude for creating surgical videos and your interest in digital photography complement one another?
Photography has been a hobby of mine since high school. Digital photography was liberating, because the finished product could be so quickly produced and highly controlled. Video has evolved significantly over the past several years. I now work in a file-based system that permits essentially instant access to highdefinition footage. Nonlinear editors provide me with an incredible level of control and enable me to create and tell a story with a moving image. With little effort, I can develop a fairly professional looking video of very high quality. These videos allow a level of sharing and education that did not readily exist when I was in training only 10 years ago. YouTube.com and other social media are largely responsible for this change. I review video recordings of each of my surgical cases, a process that I learned from my mentor in cataract surgery, Alan Crandall, MD. Focus and centration were drilled into my training experience as well. As Dr. Crandall often said, “If it looks good on video, it usually is good in the eye.” It never ceases to surprise me how much I learn from critically analyzing surgical videos on a routine basis. I am a better surgeon because I record, review, and share videos.
You speak Spanish and are learning Chinese. What are the challenges and rewards of learning a new language?
Communicating with someone in a language other than your native tongue is an experience that is worth the effort. I can pronounce Spanish words fairly well, and because of this, I often encounter patients who think I speak the language fluently. Occasionally, this results in minor misunderstandings, but my Spanish patients usually appreciate my effort to communicate with them. I can perform a routine eye examination and execute cataract surgery in Spanish. I often find that any effort on my part to enhance patients' understanding by communicating in their language fosters a deeper connection and trust.
Mandarin is a whole different context, and I was motivated to begin learning this language because my wife is Chinese. There is an incredible amount of variation within Mandarin, let alone the myriad of Chinese languages and dialects. I do my best to learn to speak along with my children, but my 5-year-old has left me in the dust in this regard. Luckily, we do not have many Mandarin-speaking patients in the Midwest.
