In his popular book, “The 7 Habits of Highly Effective People,” author Steven R. Covey warns that, “We must never become too busy sawing to take time to sharpen the saw,” implying that just because you’re successfully humming along in your work doesn’t mean there won’t come a time when things get harder, or the methods that are working so well for you now suddenly become ineffective. Because of this possibility, it often pays to look for ways to improve on your current techniques and tools today, in order to minimize the difficulties of tomorrow. In this month’s retina issue, the authors and other ophthalmologists who share their insights have taken Mr. Covey’s advice to heart.
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It’s most evident in Steve Charles, MD’s, cover story on the use of preoperative optical coherence tomography on cataract-surgery patients (p. 32). Cataract surgery is the pinnacle of what a successful, modern-day surgery should look like: It’s minimally-invasive, quick, has a low rate of complications and a high rate of success, and it features that elusive “Wow” factor other surgeries lack, by virtue of restoring a patient’s eyesight. Dr. Charles argues, however, that there’s room for improvement. By using OCT to catch retinal pathology that would otherwise be invisible—even at the slit lamp—you help ensure even better outcomes and avoid any confusion on the part of these patients in terms of what might be causing less-than-ideal postoperative vision.
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Speaking of successful treatments, not many interventions have been as successful as anti-VEGF injections for wet age-related macular degeneration. Even with anti-VEGF injections, however, says Boston retina specialist Chirag Shah (p. 26), there’s room for improvement in terms of handling non-responders. The challenge is that the treatment modality has been so successful, no one has put the time or funds into a randomized trial to determine what’s best for the unfortunate few in whom it’s not a success. Dr. Shah helps fill this research void with tips from his own practice, as well the latest data that does exist on the subject.
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Finally, nothing embodies the spirit of innovation and the quest for improvement more than the new-product pipeline, which is highlighted in Senior Associate Editor Kristine Brennan’s article on page 38. Retinal researchers and companies are hard at work on myriad ways to attack VEGF, as well as other causes of AMD, which may be able to improve on today’s already excellent methods.
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So, this month, pause for a minute, give these articles a read, and get ready to sharpen the saw.


—Walt Bethke, Editor in Chief