They say time heals all wounds, but sometimes it repeats them — even after 38 years. In 1980, in my eighth year of private practice in Memphis, Tenn, a local college professor became my patient. At age 47, he was one of my younger patients. He had an early onset cataract; its appearance was not due to any specific trauma, just one of those medical flukes that happen from time to time.

I extracted the cataract without incident, via extracapsular extraction, a much less delicate operation than today’s phacoemulsification. This required removing the nucleus in one piece, through a 120º to 140º incision, followed by aspiration. No IOL was inserted — these implants were new at the time and there were concerns about their longevity. He used a soft aphakic contact lens for three years. In 1983, I inserted a secondary posterior chamber IOL.

AN ENCORE OPERATION

I regularly saw this patient during the last 38 years. In 2015, his IOL shifted and I referred him to a colleague who repositioned it. I thought it was odd for this to occur 32 years after implantation; however, my patient had another surprise for me.

This year, with me at 76 and him at age 85, he reported having another cataract, in his other eye. He and I both joked that this was an awful long time to wait between surgeries.

Thankfully, phaco had been perfected now, giving us a fast, safe and wonderful way to treat cataracts. As before, there were no complications, and he achieved markedly improved vision on the first postop day.

Still, 38 years between cataracts is a very long time, and I am curious if any of my peers had a similar experience. One colleague of mine said his longest time between cataract surgeries on the same patient was 17 years. I wonder if anyone else has a longer time span between cataract surgeries on the same patient.

THE MORE THINGS CHANGE…

Ophthalmology has changed a lot in 38 years, and I’ve been able to incorporate many technological breakthroughs in my treatment of cataracts.

One thing has not changed, though: If you maintain a good rapport with your patients they will stick around, even for 38 years and counting. OM

David Usdan, MD, is in private practice in Memphis, Tenn.