Cataract
Winter 2025
by Mitchell Weikert, MD
Cataract Editor
It’s hard to believe another year has come and gone. As we close the door on 2025 and turn toward 2026, the theme of this EyeWorld issue—“Opening doors—redefining what’s possible”—seems like a great philosophy to embrace as we approach the new year. This might mean stepping out of our comfort zone to try new surgical techniques, adjusting our approach to surgery fundamentals, or even rethinking treatment strategies for atypical patients. In the Cataract section of this issue of EyeWorld, these “opened doors” include discussions on the perioperative management of patients with disabilities, anterior vitrectomy, and wound construction.
This might mean stepping out of our comfort zone to try new surgical techniques, adjusting our approach to surgery fundamentals, or even rethinking treatment strategies for atypical patients.
Rosa Braga-Mele, MD, Danielle Ledoux, MD, Susannah Rowe, MD, MPH, and Madhura Shah, MD, take us off the beaten path to consider how we approach patients who are differently abled and need cataract surgery. They address the unique aspects we face in the care of these patients that we don’t encounter in our typical cataract cases—issues such as the impact of cataracts on quality of life for patients who already face obstacles with respect to communication, mobility, and cognition. Other considerations like the unique role that caregivers provide in assessing changes in daily function, the lack of preparation afforded by current medical school curricula, and the benefits of adjusting our surgical approach and mindset are also covered. Although these patients often require additional time and effort, they can be some of our most rewarding cases.
While anterior vitrectomies aren’t our favorite procedures (they often mean we’re dealing with a broken capsule), they are a fundamental part of cataract surgery that we all need to deal with at some point. Brandon Baartman, MD, and Kamran Riaz, MD, provide a comprehensive discussion on anterior vitrectomy, addressing the common surgical scenarios in which it’s required, machine setting optimization, and best practices for maximizing surgical outcomes. Anterior versus pars plana approaches are also covered with recommendations on when each should be employed.
At first glance, the topic of cataract surgical incisions may seem a little basic, but it never hurts to revisit the fundamentals. Surgical challenges often have a snowball effect, especially when they involve steps at the very beginning of cases. With this thought in mind, poorly constructed surgical incisions add stress, time, and risk to otherwise straightforward cases or can increase the complexity of already difficult cases. Sumit “Sam” Garg, MD, Richard S. Hoffman, MD, and Kevin M. Miller, MD, delve into the ins and outs of clear corneal and scleral wound construction. In addition to providing instruction on optimal wound structure, they discuss the astigmatic effect of different incision geometries and the benefits of incisional enhancements, such as the Wong pocket.
We hope this issue of EyeWorld will help you open your own doors and redefine what’s possible for yourself as you pull out a new calendar and enter the new year.
