Viewpoint

On cataracts, bearing witness and miracles

GUEST EDITORIAL

By Johnny L. Gayton, MD

Cataracts, their treatment and lack thereof have robbed people of quality and quantity of life since the first blink. In the King James translation of the Bible, the loss of vision with age was described as “eyes growing dim.” Cataracts likely changed the course of history when Jacob took advantage of his father Isaac’s dim vision and stole his brother’s birthright. Jacob, later renamed Israel, is considered a Patriarch of the Israelites and appears in many sacred scriptures, including the Hebrew Bible, and the Quran. Isaac’s cataracts let Jacob secure his place in history — an unlikely event in 2016, as we’re in a much better position to protect a person’s birthright from thieves due to cataracts.

Striving — and sharing

When I began performing cataract surgery in 1980, we were still prescribing aphakic spectacles. I remember many a patient falling due to visual distortion after surgery; some were severely injured. I began my quest to get my patients the best-uncorrected vision possible after starting private practice in 1983. I learned from many of the greats, including Robert Osher, MD and others who shared their knowledge with a green 27-year-old eager to learn.

But despite good surgery, I noted how many patients were debilitated from astigmatism that progressively increased after cataract extraction. I decided in late 1984 that this was due to the blinking process stretching the superiorly placed cataract incision. So I shifted my cataract incision to the temporal position — and was pleased to see my patient’s problems with astigmatism markedly decrease. Many innovations in cataract surgery result from surgeons reviewing their outcomes, tweaking their techniques and reporting their results so all can benefit.

Experiencing the miracle firsthand

In 1998 I learned first-hand how cataracts can obstruct quality and almost quantity of life. I knew I was developing posterior subcapsular cataracts, but did not realize how much they were affecting my night-driving vision until one evening when I pulled into what I thought was a driveway and almost plummeted down a huge ravine. I wasted no time after that — I scheduled surgery with my mentor and friend, Dick MacKool. Then I experienced how spectacular cataract surgery can and should be. At one day post-op, I was back in the office and at two days post-op, performing surgery. Since then, I have performed thousands of eye surgeries, won several world power-lifting championships and become a pro wrestler. Can you imagine doing those things wearing, and tripping, with aphakic spectacles?

I am closer to the end of my career than the beginning, and thankful to God to have chosen a career in which I am dedicated to helping people. If I were to start over, I would unhesitatingly choose the same path. OM