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Cataract Surgery in 2023: What should you expect?

By David A. Goldman MD –

While there are certainly new developments in cataract surgery every year, these pale in comparison to the innovations that occur over decades. While many of the technologies discussed in this article are currently available in trials, it is important to remember that they are still in trials for a reason. Once safety data has been confirmed and designs have been optimized, cataract surgery in the next decade will be revolutionized.

To begin, the way surgery is performed will have completely changed. Today, cataract surgery is typically performed with a high-frequency microincisional ultrasound device. While it is very safe and provides great results, it is still dependent on the skill of the surgeon. In the next decade, these steps will likely become completely automated by computer and performed by a femtosecond laser. While these lasers are currently
available in some areas of the country, the technology still needs some development – for example the surgeon controlled ultrasound device is still required to be used. That said, the rate at which these lasers are improving is impressive to say the least, and they will certainly play a role in cataract surgery in the future.

With intraocular lenses, exciting advances are also coming. The light-adjustable-lens (LAL) is currently under clinical trials from Calhoun vision. This lens contains
components that are photopolymerized upon exposure to ultraviolet light. In essence, applying specific light onto the lens after implantation can not only correct refractive error (nearsightedness, farsightedness, astigmatism) immediately following surgery, but may even hold potential to adjust the patient’s refraction as they age if needed. Another interesting technology is the FluidVision lens from Powervision. Instead of a fixed firm lens that is implanted into the eye, this lens contains fluid and channels that allow the shape of the implanted lens to change just like the eye’s natural lens. This changing shape of the lens, referred to as accommodation, is the reason why most young people do not require glasses at all. Once an artificial lens is able to accommodate the same extent as the young human eye, we may be able to throw our glasses away forever.

Ultimately, over the years many exciting technologies come and not all turn out to deliver on what they had promised. That said, the products mentioned in this article have already done well in early testing and, though far from perfect, hint at a very exciting future for us all to see.

Prior to founding his own private practice, Dr. David A. Goldman served as Assistant Professor of Clinical Ophthalmology at the Bascom Palmer Eye Institute in Palm Beach Gardens. Within the first of his five years of employment there, Dr. Goldman quickly became the highest volume surgeon. He has been recognized as one of the top 250 US surgeons by Premier Surgeon, as well as being awarded a Best Doctor and Top Ophthalmologist.

Dr. Goldman received his Bachelor of Arts cum laude and with distinction in all subjects from Cornell University and Doctor of Medicine with distinction in research from the Tufts School of Medicine. This was followed by a medical internship at Mt. Sinai – Cabrini Medical Center in New York City. He then completed his residency and cornea fellowship at the Bascom Palmer Eye Institute in Miami, Florida. Throughout his training, he received multiple awards including 2nd place in the American College of Eye Surgeons Bloomberg memorial national cataract competition, nomination for the Ophthalmology Times writer’s award program, 2006 Paul Kayser International Scholar, and the American Society of Cataract and Refractive Surgery (ASCRS) research award in 2005, 2006, and 2007. Dr. Goldman currently serves as councilor from ASCRS to the American Academy of Ophthalmology. In addition to serving as an examiner for board certification, Dr. Goldman also serves on committees to revise maintenance of certification exams for current ophthalmologists.

Dr. Goldman’s clinical practice encompasses medical, refractive, and non-refractive surgical diseases of the cornea, anterior segment, and lens. This includes, but is not limited to, corneal transplantation, microincisional cataract surgery, and LASIK. His research interests include advances in cataract and refractive technology, dry eye management, and internet applications of ophthalmology.

Dr. Goldman speaks English and Spanish.

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