Book review

Media Type: Textbook (Hard cover)

Synopsis: Dr. Chang and associates have assembled an extraordinary group of experienced ophthalmologists and business consultants to create a comprehensive compilation of every aspect of refractive IOLs, ranging from marketing and patient selection/evaluation, to detailed comparisons of all currently available refractive IOLs, to the subtleties of surgical technique and complication management. To suggest that the work is comprehensive is a major understatement, for it is truly encyclopedic! I predict it will serve at the definitive reference in this rapidly advancing field for at least 5 years, and thus is a required reading for any serious refractive cataract surgeon.

Target Audience: Cataract surgeons

Review: I already owe a great debt to Dr. David Chang, as his previous opus, Phaco Chop (Slack Inc., 2004) raised the level of my own phacoemulsification surgery to a new high. Thus, when invited to review Mastering Refractive IOLs: The Art and Science , I was quick to accept, knowing that another work of Chang would undoubtedly be of similarly high quality. Yet, I could simply not anticipate that Dr. Chang and associates had now upped the ante to truly magnum opus proportions! Indeed, the new “Chang Gang”, numbering 222 “Who’s Who in Cataract Surgery” co-authors from Abbott to Zalaznick, bangs its way through 236 chapters in terse, highly focused style.

In proposing to span both the art and the science of refractive IOLs, and recognizing that the task is both multidisciplinary as well as multidimensional, the work truly covers all bases … and then some. The breadth of this scope is self-evident in the book’s 14 sections:

  • 1

    Why offer premium IOLs?

  • 2

    Transitioning to presbyopia-correcting IOLs

  • 3

    Transitioning to presbyopia-correcting IOLs: Quick start guidelines

  • 4

    Presbyopia-correcting IOLs today

  • 5

    Presbyopia-correcting IOLs in the future

  • 6

    Refractive IOLs – Quality of vision

  • 7

    Patient selection and education

  • 8

    Presbyopia-correction IOL selection

  • 9

    Preoperative ocular assessment

  • 10

    Managing astigmatism

  • 11

    Premium cataract surgery

  • 12

    Refractive lens exchange

  • 13


  • 14

    Complications – Avoidance & management

Obviously to fit all 236 chapters into even a 915 page to me suggests that the average chapter length is slightly less than 4 pages, and so it is that individual chapters are invariably tight as they seek to treat a very narrow aspect of the whole, such as:

  • What is a premium IOL worth?

  • How do I get started with IOL XYZ?

  • IOL XYZ – Clinical pearls

  • Why offer multiple premium IOLs?

and on and on.

A unique feature of the contents is that multiple chapters deal with exactly the same subject. But this duplication is, in fact, a strength – a soliloquy Panel Discussion of sorts – as, for example, who would not welcome learning the advice of Drs. Chang, Devgan, Little, Braga-Mele, Fishkind and Arbisser, each of whom has written the identically titled chapter, “ Pearls for improving your cataract surgical skills .” And this same approach is a recurrent theme as there are 3 chapters entitled, “ Refractive surgery and IOLs – Future trends ” (by the Fine, Lindstrom, Nordan triumvirate, no less), 6 chapters dealing with “ Transitioning from keratorefractive to refractive IOL surgery ,” 6 treating “ Managing patient expectations ,” to enumerate but a few. Thus, apart from being admonished to “under promise and over deliver” more than 100 times, there is remarkably minimal waste, as repetition of themes remarkably avoids redundancy of content.

Moreover, this book truly has something for everyone. Recognizing that “every light casts a shadow,” complication avoidance and management receives 18 chapters and 75 text pages. There’s stuff on torics; there’s stuff on LASIK; there’s stuff on optics, pseudoaccommodation, and neuroadaptation. And monovision Luddite that I am, both professionally and personally, there are even chapters by McDonald, Maloney and Barrett presenting this low tech, no cost alternative.

In summary, and in a word, David Chang & associates plus All-Star cast of (almost) thousands have again said and done it all. This work compiles the entire history and current status of refractive IOLs and even looks ahead to the near horizon. It is exceptionally well written, referenced, illustrated, and indexed. It defines the Gold Standard of refractive IOL state-of-the-art and state-of-the-science. It will be the standard reference in this rapidly advancing field for at least the next half decade. It is “required reading” for every serious refractive cataract surgeon and for all who aspire to become so.

So thank you David, Steve, Warren, Dick and Kevin et al for once again showing us the way.

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Jan 17, 2017 | Posted by in OPHTHALMOLOGY | Comments Off on Book review

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