It is human nature to welcome the new year by looking ahead to speculate about what the future may hold. This got me thinking about looking forward in regard to cataract surgery. But instead of a year forward, how about 25 years forward? Will we have tackled the problems we currently wrestle with regarding cataract surgery? How much different will the landscape be for surgeons and ASCs in 2050?
One big problem that we’re wrestling with is the issue of declining reimbursement. Will cataract surgery be paid for in the same way 25 years from now, or will government bureaucrats recognize that continual yearly cuts are unsustainable and develop some other form of valuation? Is it likely that in 25 years, the only way for practices to be profitable offering cataract surgery will be for most patients to choose a premium lens package? Will cataract surgery be more concentrated into a few large ASCs, or will an increase in office-based surgery spread procedures out to many smaller practices? What about the issue of the ever-growing population that will need surgery and the declining number of surgeons available to perform these procedures? How will anesthesia services fit into the picture—with declining resources and fewer anesthesia personnel, will they still be part of the team? I imagine that physician assistants and other extenders will become a more integral part of the process, reducing how much surgery the surgeon performs.
What will cataract surgery itself look like in 25 years? The field of robotics is just now starting to find its way into ophthalmology. Where will this technology be by 2050? Will the role of lasers increase, or will the cost be too high for their role to grow? Artificial intelligence (AI) has already begun to impact our specialty, and one can only imagine that the role of AI will continue to expand in ways we can’t fully recognize today.
The last 25 years have seen dramatic advancement in lens technology. One can only imagine what lens technology will look like in another 25 years. Adjustability of lenses is in its infancy today, but in the years ahead customization and adjustability will probably take giant leaps. Will we have solved the problems of dysphotopsia and night glare? Clear vision through all ranges with minimal to no side effects is the Holy Grail of cataract surgery. In 25 years, will we have achieved that for our patients?
One thing is certain in the world of ophthalmic surgery—that it’s always changing. OASC
