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Business & Profession Business and Innovation, Retina, Health Economics and Policy

The Mother of Invention

Articles like this month’s cover feature are the kind I enjoy the most. They speak to the future of ophthalmology, they tell the stories behind the work that’s going to open up whole new ways of treating ocular disease, and revolutionize how surgeons will work in the future. We all know that there aren’t enough ophthalmic surgeons being trained to deal with the onslaught of aging baby boomers with age-related eye disease. They are already filling clinics to the brim and extending the workload of many surgeons far beyond the 9-to-5 they’d be delighted to work. For the baby boomers, that outlook is starting to look quite grim. For example, there are number of modifiable risk factors associated with the development of retinal disease – sun exposure, smoking, nutritional status, but the effect is cumulative – and the later the intervention, the more diminished the returns. For younger generations, more ubiquitous (smartphone) screening and earlier interventions will help. The boomers, however, need more dramatic interventions, sooner rather than later.

For them, the good news is that after decades of promise, gene and stem cell therapies look like they’re coming of age just in time. But it’s currently very expensive and needs the best surgeons in the world to successfully perform these profoundly challenging procedures like subretinal implantation of cells on a hydrogel scaffold. Thank goodness for robotic assistance.

I think this is a prime example of necessity being the mother of invention – and the robots are going to be essential to unlock the potential of regenerative eye medicine – and also helping get through the huge caseloads of less exotic surgeries as safely and efficiently as possible. Unless you want significant portions of the post-war generation to go undertreated and rendered increasingly more dependent on the help of others to get by – for the sake of a treatable ophthalmic disease – thank goodness for the robots.

One thing I’ve noted – nobody wants to see autonomous surgical robots (even though that’s technically feasible in some procedures elsewhere in the body even today). But if robots are to be adopted, surgeons will remain in control for a long time to come. One thing is for certain though, for the sake of our older generations’ sight, there’s no stopping them. The robots will soon be here. I, for one, want to welcome our new robot overlords – you.

Mark Hillen

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