Recently, I had the opportunity to reflect on ophthalmology in 2008 with
Dr. John Kitchens, retina specialist in Lexington, Kentucky.
DG: Dr. Kitchens, what have you seen as some as the best advances for retina in 2008?
JK: On the surgical front, one of the major advances I have seen is the new Constellation system produced by Alcon. It's the first time we have had duty cycle control with an Alcon product. The new cutting technology allows for less peripheral traction on the retina as well as faster removal of the vitreous. Hence, it is not only faster, but safer. The machine also has a variety of other helpful features including: its own self contained gas system, pneumatic driven forceps, video tutorials to guide inexperienced surgical technicians in setup to name just few of the perks. On the medical side, the results of a major Diabetic Retinopathy Clinical Research (DRCR) Network showed us that in the short-term intravitreal steroid may result in a reduction in clinically significant diabetic macular edema but focal laser is more efficacious in the long-term1. Most exciting is probably the CATT study which began in January. I think everyone is looking forward to hearing the final results of this study comparing Avastin to Lucentis in the treatment of exudative AMD.
DG: What do we have to look forward to in 2009?
JK: Bausch and Lomb will be releasing their posterior chamber surgical system which will have a higher cut rate and will allow for more efficient small gauge surgery. They may have a more competitive price – something that will be important to consider given the status of the economy and retina surgeons' desires to move in ASCs.
DG: Any advice for graduating retina fellows?
JK: Narrow down your job search early. You can really stretch yourself traveling for multiple interviews in different locations. Try to decide on a geographical location you would like to work in, and contact the groups that are practicing there, rather than just looking at groups that are advertising a position. Don't be afraid to speak to your attendings and surgical reps to find out more about physicians. The prospective practice will be calling your faculty to find out about you and it's important to know what type of practice and what work culture you will be joining.
DG: Your favorite moment of 2008?
JK: The election of Barack Obama. I don't think they'll be too much of a change his first year in office for ophthalmology. Hopefully, he'll be able to solve the crisis of uninsured people we have in the US.
- A Randomized Trial Comparing Intravitreal Triamcinolone Acetonide and Focal/Grid Photocoagulation for Diabetic Macular Edema. Ophthalmology 2008;115:1447-1459.e10.
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