This past year, my 16-year-old daughter and I have been working together to each earn our private pilot’s license.
Each lesson has been a wonderful daddy-daughter date, although remaining calm in the back seat while she lands a Piper Archer has been so much tougher than biting my tongue while she parks our Subaru.
I’ve been astounded by the number of parallels between flying and surgery. One of my favorite flying axioms is: “Truly superior pilots use superior judgment to avoid situations where they have to use superior skill.” Substitute “surgeons” for “pilots,” and it’s still spot on.
Advanced refractive lens implants are truly life-changing for so many patients, yet we all can be challenged by screening patients effectively. Biometric tools such as OCT detect macular problems, and topography detects higher-order aberrations and corneal abnormalities. Both are extremely useful to assess candidacy. We also have psychometric tools such as MDbackline’s automated patient questionnaire and Visual Profile Report that highlight red flags in patients’ expectations and motivations. All of these tools can help us sort out a few clear noncandidates.
Superior judgment doesn’t, however, mean turning every motivated patient down just because of a red flag. Refractive cataract surgery truly improves lives, reducing falls associated with bifocals and progressive lenses and giving patients confidence and freedom for activities that weren’t possible with glasses or contacts. We have to take calculated chances with informed patients to give them what they truly want and deserve, and the newer IOLs (trifocal, extended depth of focus and light adjustable) have delivered so well for many patients who were previously “untouchable.”
Still, “it’s better to be on the ground wishing you were in the air than in the air wishing you were on the ground.” We’ll regret fewer of the refractive cataract patients whom we turned down for a multifocal than those where we stretched the limits of candidacy too far. And what to do when we face the unknowable, unsatisfied patient? Well, we practice and re-practice emergency landings for a reason, and the IOL exchange is our emergency landing for the patient whose outcome defied all our best judgment. For an “eye pilot,” it’s a skill as important as a perfect touchdown.
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© 2021 Healio All Rights Reserved.