Cornea
Fall 2024
by Julie Schallhorn, MD
Cornea Editor
Clinicians are finely tuned to their patients and to their practices. When something unexpected happens, it is a jarring contrast to the routine of daily clinic life and an unexpected intrusion into the pattern of patient care.
Naturally, we look for a cause—is it the new technique I tried? The Ozempic (semaglutide, Novo Nordisk) that patients always seem to be on these days? Maybe this type of IOL is more sensitive to decentration? We study, such as by reading the excellent article on endothelial pathology in this issue featuring Francis Price Jr., MD, and Zeba Syed, MD. Being responsible physicians, more often than not, we seek council with our peers to inquire if they have had the same experience.
As physicians and scientists, it is our duty to move past rumor and hypothesis and get to the bottom of the story. I challenge our readers to think critically about the experiences and the anecdotes they encounter on listservs, chat groups, and social media.
This is where things get complicated. More and more, we are turning not to close peers or to trusted mentors but instead to the wisdom of the collective that is available to us through the numerous chat groups and listservs that have multiplied in recent years. These can have wonderful benefits. I first learned about intrascleral haptic fixation (the Yamane technique) through a listserv, and I have heard numerous positive experiences from friends and trainees. Many new devices and drugs, like the novel crosslinked polymer discussed in our punctal occlusion article featuring Eric Donnenfeld, MD, Mina Massaro-Giordano, MD, and Darrell White, MD, are discussed in such forums.
At the same time, I became aware of how listservs, much like social media, have the power to amplify some opinions, sometimes in the absence of much data. One key example of this is the increase in primary graft failure that Christopher Ketcherside, MD, Elmer Tu, MD, and W. Barry Lee, MD, discuss in this issue. The data shared by Dr. Lee is conclusive—the number of reported primary graft failures has increased but only to a total of 45 out of approximately 50,000 transplants performed in the U.S. every year. Is this a true increase? Or is it an increase in reports to the EBAA prompted by stories shared on listservs? Are the anecdotes being shared backed up by true data? Are we living in a cornea rumor mill?
Any good research study starts with a clinically relevant question. “Is there an increase in primary graft failure?” is an excellent one. As physicians and scientists, it is our duty to move past rumor and hypothesis and get to the bottom of the story. I challenge our readers to think critically about the experiences and the anecdotes they encounter on listservs, chat groups, and social media. Through critical (and most essentially, civil) discourse in these settings, we can ask these questions and lead ourselves to the truth, for the betterment of ourselves and our patients.
