• Uday Devgan, MD, focuses his blog on premium-channel IOLs, including accommodating, multifocal, toric, and other innovative designs. Current techniques, research, trials, issues, and case studies will be presented with an emphasis on surgical and clinical pearls for maximizing patient results.

Tuesday, December 31, 2013

Photo quiz: Corneal edema after uneventful cataract surgery

Uday Devgan, MD

This patient had uneventful cataract surgery 2 weeks earlier and presents with 20/25 vision with some peripheral corneal edema and persistent cell and flare (Fig. 1). Does everything look good to you and are you ready to schedule surgery for his other eye?   Fig. 1. This patient has 20/25 vision but some inferior corneal edema after cataract surgery 2 weeks earlier.  Since the corneal edema is focal, inferior in this case, is there a reason why this would be present 2 weeks afte...

Tuesday, September 24, 2013

$1 million mistake? Not for ophthalmologists

Uday Devgan, MD

The title of a recent CBS article certainly grabbed my attention, “$1 Million Mistake: Becoming a Doctor.” With a title like that I just had to click on the link to read the article.

It turns out that a recent survey of physicians showed that most were dissatisfied with their jobs and most would not choose to go into medicine if they were able to do it all again. That comes as a surprise to me since just about every ophthalmologist I meet enjoys helping patients and performing ocular surgery. Sure, when it comes to paperwork, reimbursement and bureaucracy, we are in the same boat as the other physicians, but there's something special about being trusted with our patients' most precious sense, their sight.

Friday, August 30, 2013

Extra caution needed in cataract surgery for retinitis pigmentosa cases

Uday Devgan, MD

Patients with retinitis pigmentosa develop cataracts earlier in life and surgery for these patients presents some challenges. While these patients have relatively soft cataracts, primarily with posterior subcapsular changes, there are other aspects which make their surgery more difficult. The zonular apparatus tends to be weaker in these patients and have a higher incidence of developing anterior capsule phimosis. In addition, the risk of cystoid macular edema is higher and these patients ofte...

Thursday, August 1, 2013

Should ophthalmologists-in-training be allowed to use a femtosecond laser to assist in cataract surgery?

Uday Devgan, MD

I was communicating with a colleague who was adamant that ophthalmology residents should not use a femtosecond laser to assist in cataract surgery since it would hinder the development of their manual skills. That's a reasonable argument, but I have a different perspective.

I think femto allows beginning surgeons, or those who are not as proficient at manual phacoemulsification, to achieve better results. For a more experienced or proficient surgeon, the benefits of femto phaco are less pronounced.

Tuesday, June 18, 2013

On-label and off-label discussions

Uday Devgan, MD

My residents were surprised when I explained to them that there are two distinct kinds of physician meetings and that the content of each is markedly different. Industry-sponsored promotional discussions In these programs, such as local dinner talks where a speaker talks specifically about a pharmaceutical or surgical product, the content is strictly limited. Because an ophthalmic company is sponsoring the event, the slides and the content of the talk must be strictly limited to on-label disc...

Wednesday, May 22, 2013

Treating an anatomic problem vs. providing an improved functional outcome

Uday Devgan, MD

A patient presented to me recently with a history of cataract surgery in the left eye done a year ago.

He had a wide superior scleral tunnel incision and what appeared to be an anterior chamber IOL with the part of the haptics above the iris at the angle and the rest of the IOL in the sulcus. The anterior segment was quiet and without inflammation, and the patient's only complaint was the poor vision, which was 20/800.

Wednesday, May 8, 2013

Remembering Dr. Stephen Ryan – the giant and the gentleman

Uday Devgan, MD

While a medical student at USC, I was fortunate to interact with Stephen Ryan, MD, as both dean of the medical school as well as professor of ophthalmology. He will certainly be remembered as a giant as well as a gentleman in the ophthalmology world.

Friday, March 15, 2013

Interesting presentations highlight Oregon meeting

Uday Devgan, MD

I had the pleasure of recently attending the Oregon Academy of Ophthalmology annual meeting in Portland. I enjoyed connecting with many colleagues and friends, including Devin Gattey, MD, with whom I did a charity trip to Vietnam, and Yujen Wang, MD, who was a co-intern with me many years ago. I even managed to spend a few hours enjoying the city and visiting the Casey Eye Institute, but the highlight of the meeting was the content of the presentations.

Friday, December 21, 2012

Social media in medicine: at what price?

Uday Devgan, MD

Social media has become the new buzz in many businesses, which see it as an avenue for increased revenue. People trust their own social circle and friends, and if one of them makes a sincere recommendation in support of a product, an event, a business or even a surgeon, it carries a lot of weight. But the key here is a sincere recommendation — not a recommendation that a friend may be making in return for monetary compensation. There are many businesses that extend discounts to customers ...

Tuesday, December 11, 2012

Follow-up with a patient

Uday Devgan, MD

About 6 weeks ago, I wrote about a young man who suffered iris damage and developed an exotropia after a penetrating injury from a car accident.