Dr. Wang has performed on 5500 patients, including 4000 medical professionals.

(i) for cataract surgery, how many different kind of implants can you choose? And how do you decide which type to choose?

There a single vision vs multi focus.

It’s very important to carefully screening for the right candidates to do multifocal lenses implant.

Normally Dr Wang would have 80 to 90% disqualifying ratio, after conducting 40 to 50 items of screening, including hours of conversation and prepping.

The major side effect are :

1. due to photon split, patient normally required significantly higher intensity of lighting in order to see clear.

2. Glare 炫光reported in about 40 to 50% of patient. But only less than 5% have long-term problem that bothers.

3. It often takes 6 to 12 months for patient to get used to or to improve glare. At the end, about 5% we suffer long-term problems with the glare.

4. Multifocal implant is not for people who is theory picky about their vision.

5. It is likely to have reflective surgery done on the cornea if there is any residual reflective error.

YAG laser that commonly performed to remove opacity in the posterior sac, typically 3 to 6 months after cataract surgery. It could be up to 70 to 80% postcard eye surgery. Patient formed opacity that could be helped by YAG Laser treatment

“If you do YAG laser, you marry to the IOL”

But there is an important issue brought to the consideration of IOL choice. Any possibility of exchange in intraocular lenses has to be ruled out prior to YAG, as the corporations have the posterior lens sac membrane significantly increases the danger of such replacement. So pre-surgery consultation is crucial.

Multifocal contact lenses trial prior to cataract surgery might helped to screen candidates. But the optics and vertex distance could very different in patients experience, to decrease the usefulness of such trial.

(ii) AMCL 65778 is one of the top three insurance reimbursed procedure in ophthalmology procedures. It has been used in most country treating significant cornea, scarring, infection, and even dryness.

(iii) the real mechanism of presbyopia is not so much as the accommodative muscle fatigue and aging, it is more about hardening and thickening of the crystalline lens that makes flexing more difficult. So a new research of scleral widening procedure in undergoing currently, which could allow more room for aging thicker lens to change the shape during accommodations, ie allowing adjustment for near reading.

(iv ) SMILE small incision, Laser treatment only affect about 30° of the cornea, comparing to traditional Lasik, which affects 270° of the cornea, that could damage up to 80 to 90% of the nerve endings. That’s the reason SMILE could significantly reduced the possibility surgery induced significant dry eyes. SMILE leaves 80% of the cornea nerve intact, which often creat a very small, only a few millimeter incision that could be barely visible under slit lamp examination.

Unfortunately, only about 5% of of ophthalmologists are performing small incision SMILE.

(iv) refractive lens exchange it’s only perform in less than 1% of the Ophthomologist clinics.

Dr Wang give a very interesting perspective in the timing of performing surgery. He asked, why wait till 70 or 80 to do surgery and regain the optimum vision quality, Where many people in their 50s or 60s already experienced with used vision quality because of increasing lens opacity. Is their quality of lives equal or more important?

Most insurance do not cover the procedures mentioned above, ie small incision, multifocal intraocular, lens, refractive lens exchange (Which cost approximately $3000 self pay).

When asked how to choose the best surgeon to perform surgery needed, Dr Wang was very straight and frank. He replied, 1) look into the publications. Normally people who involved in research and write up reviews and books are those stay on top of the game. 2) ask how many times have they done that particular surgery. Or what percentage of that particular surgery was done. 3) how many medical professionals have been your patients?

Dr Wang also shared his question faith and was openly announced that science and faith and come together in our profession works.

He also share his views about how he dealt with racial discrimination. In his opinion, only the four aspects are claiming fair representation, would people consider winning the battle of discrimination: political representation, media representation, legal representation, and benefits representation.

He encourage all of us to share our life stories, and make a difference in this country.