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Eyetube Picks | June '13

The World of Ophthalmology

Ihave been blessed with the opportunity to travel internationally to further my education in ophthalmology. In 1997, I worked as a medical student at Dr. Svyatoslav N. Fyodorov’s eye hospital in Moscow. I was amazed at the audiovisual setup he had! The hospital included more than 40 operating rooms with video hookups to Dr. Fyodorov’s office where he had a wall of televisions so he could observe video, and there was two-way audio for him to chime in and discuss the progress of the case with his surgeons. When surgeons had cases that were not going as planned, they learned they could adjust the operating microscope so that the camera would not pick up everything. Dr. Fyodorov later learned to watch for that trick as a clue something bad was happening and that he needed to jump in. Dr. Fyodorov was ahead of his time in many ways; not only did he help pioneer radial keratotomy and IOL technology, he was always on the cutting edge with his use of surgical video footage and its importance for education.


In 2003, I traveled to India to learn bimanual phacoemulsification from Dr. Amar Agarwal. On the second day of surgery, Dr. Agarwal did not appear in my operating room. I was feeling a bit abandoned, because I had traveled all this way to learn from the pioneer of bimanual phaco, and he was not there to walk me through the cases. At the end of the day, he pulled me in his office, and like Dr. Fyodorov, he also had direct video linked to all of his OR microscopes. I soon realized he had been watching all my cases, and he had prepared video excerpts of certain ones to review with me in person. Dr. Agarwal has a huge video library covering many pioneering surgical techniques. One of my favorites is the glued IOL.


Soon, I plan to travel to Canada to see the Kamra corneal inlay (AcuFocus, Inc.) in action. As I live in Ohio, this is an easy drive or quick flight over the border, and the trip will afford me an opportunity to potentially comanage patients who received implants with this technology performed by a Canadian surgeon. Assuming we proceed with this strategy, it will be important to understand the potential surgical implications that may be required of a comanaging surgeon. This video shows how to laser enhance a previous Kamra inlay patient and reposition a misaligned inlay.


Before investing in a femtosecond laser, my partner and I literally I traveled around the world to experience firsthand the nuances of each platform. We visited Salt Lake City, Utah; Lima, Peru; and Santa Domingo in the Dominican Republic to observe the various systems. Now that most units have been in use for some time, there are many videos available to guide potential buyers and help them save time and effort by avoiding lengthy travel. These are some of the best videos found on Eyetube explaining the features of the four femtosecond laser cataract systems.


In addition to having the opportunity to visit great surgeons and view live surgery, there are many travel opportunities offered by fantastic national and international meetings. I look forward to flying to Cannes, France, for the upcoming American-European Congress of Ophthalmic Surgery meeting, and I encourage everyone to make the trip. I guarantee a great meeting in a fantastic setting.

William F. Wiley, MD

William F. Wiley, MD, is the Medical Director of the Cleveland Eye Clinic/Clear Choice LASIK Center in Cleveland. Dr.Wiley may be reached at drwiley@clevelandeyeclinic.com.

June '13