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Technology Gap Between The United States And Europe | Oct 2015

Top 5 Reasons US Surgeons Felt Annoyed After ESCRS 2015

We asked four of our favorite frequent fliers, “When you attend international meetings, what bugs you the most about seeing what other surgeons have available to them?”


No. 1. Lack of the complete gamut of presbyopia-correcting IOLs, specifically toric multifocals and trifocals

No. 2. Lack of the latest Visian ICLs (STAAR Surgical), especially a toric version to simultaneously correct astigmatism and the Centraflow version to avoid the need for preoperative iridotomies

No. 3. Continued FDA monitoring of safety and efficacy. For example, the FAA only monitors safety like the CE Mark. The FAA does not tell Boeing how to build airplanes. I wish the FDA would move to an FAA or European CE Mark safety concern-only level so more products could come to market faster. Surgeons will not use a product if it is not effective, so there is no reason for the FDA to continue to monitor efficacy.

No. 4. Lack of the Sulcoflex IOL (Rayner Intraocular Lenses) to be used as a piggyback IOL

No. 5. The Best DJs in the world and the best eletronic dance music shows are in Europe.


No. 1. Everything is so expensive because of how poorly the US dollar has been performing.

No. 2. The IOL choices, including multifocals, are so much more extensive internationally than in the United States.

No. 3. Startup biotech companies are doing more clinical research outside the United States than inside due to the more conducive approval process.

No. 4. Electronic health record mandates and other governmental regulations are much less prevalent in most other countries, making them more enjoyable and financially viable practice environments.

No. 5. It is very difficult to find a Starbucks when you really need a cup of good, strong coffee.


No. 1. The time change—still no great way to avoid jet lag

No. 2. The lack of US-style air conditioning and heating, not to mention the difficulty of getting ice for a cold glass of anything

No. 3. Going to a symposium about the best lens implant ever only to find that it may never make it to the United States

No. 4. Finding out that technology that I do have access to in the United States has new and better software/hardware available that I will not get a hold of for years

No. 5. Colleagues who can speak foreign languages


European meetings do not depress me. They are a wonderful opportunity to learn about new technologies that may arrive in the United States in the future.

Certainly, there are some technologies that I am anxiously awaiting. Although it can be frustrating when the delay is on the order of many years, it is not uncommon for the most promising technologies being used in Europe to have further improvements before reaching the United States. A case in point is Kamra (AcuFocus), which was relatively successful when initially launched in Europe and Asia. However, over the few years that were required to achieve an FDA approval, the technology made significant improvements (such as switching from a flap to a pocket and enhanced femtosecond laser settings), which resulted in significant improvements in patient outcomes

Of course, one of the important reasons to attend European meetings is that there is top-level research that is presented by European clinicians. From corneal collagen cross-linking to presbyopia-correcting IOLs, international surgeons really make a difference in how we US surgeons will eventually be able to care for our patients.

Mitchell A. Jackson, MD
• founder and CEO, Jacksoneye, Lake Villa, Illinois
mjlaserdoc@msn.com; Twitter @djmjspin
• financial interest: none acknowledged

Robert J. Weinstock, MD
• cataract and refractive surgeon in practice at The Eye Institute of West Florida in Largo, Florida
(727) 585-6644; rjweinstock@yahoo.com; Twitter @EyeInstituteWFl
• financial interest: none acknowledged

Jeffrey Whitman, MD
• president and chief surgeon, Key-Whitman Eye Center, Dallas
(214) 754-0000
• financial interest: none acknowledged

William B. Trattler, MD
• director of cornea at the Center for Excellence in Eye Care in Miami
(305) 598-2020; wtrattler@earthlink.net; Twitter @wtrattler
• financial interest: none acknowledged

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