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    Caught between a husband and a wife: A cautionary surgical tale

    Editor’s Note: Ophthalmology Times introduces “Eye Catching: Let's Chat,” a blog series featuring contributions from members of the ophthalmic community. These blogs will be an opportunity for ophthalmic bloggers to engage with readers with about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series kicks off with this blog by Mark Packer, MD, FACS, CPI, who travels a cautionary surgical journey with a husband and wife. The viewpoints expressed in these blogs do not represent the viewpoints of Ophthalmology Times and UBM Advanstar.


    Dr. Packer"Old Hank" came to see me with a special request.  This was about 12 years ago, and he wasn’t really that old.  Also, his name was not actually Hank, but he had recently retired from truck driving, so he had the air of an old timer.  He had a respectable beer belly, spoke slowly, and repeated things a few times to make sure you understood them. 

    Further reading: What dying wishes or regrets do ophthalmologists have?

    Hank had been driving a truck around the United States for more than 40 years.  His wife, Carol, had always stayed home.  Now that he was retired, he wanted to show her all the places he’d been while she was raising the kids.  He told me about the RV he planned to buy, and some of the routes he had in mind.  And there was one more thing.

    “I am sick and tired of wearing bifocals,” he said, “and I don’t want to have to mess with glasses to drive or read maps.” 

    He had heard about Refractive Lens Exchange from an interview I had done on a local TV health program, and if the surgery worked for him, he wanted his wife to have it, too, so they could both enjoy the sights.

    Hank was farsighted and had a small amount of astigmatism, so without his glasses everything, near and far, was a blur.  Otherwise, his eyes were healthy.  He didn’t have cataracts, and except for the big belly, he looked like he was in decent shape.

    NEXT: Mystery continued

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    • Dr. Rosenthal
      Dr Packer is a fine ophthalmologist and I have much respect for him and his ability. However, and this is not hindsight, I would never have put a multifocal implant in the wife in this case. It is possible that I wouldn't have operated on her at all. First, I never recommend a multifocal implant in a diabetic and I very carefully explain to them why. Secondly, I go over all the disadvantages of a multifocal with the patient and try to explain other options. Thirdly, I always want to know if the patient is adamantly opposed to wearing glasses and explain that the final visual outcome will never be as good with a multifocal as it will be with distance IOL and glasses (though this does not apply in this case since no cataract was present). And lastly, I ALWAYS make sure that any surgery, and especially a multifocal implant, is what the patient herself/himself wants and is not someone elses idea. This policy has always served me and the patient well. One unhappy postsurgical patient can make you miserable no matter how many happy ones you may have.


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