Options Provide Control

We can increase our ability to best serve our patients by staying abreast of choices

“We love having control,” writes behavioral psychologist Susan Weinschenk, in a Psychology Today article. The reason: Having control is a part of our survival instinct. (See .) She also points out in this article that choice provides control. Thus, if we want to fully meet the needs of our patients, should we offer a variety of options to do so? What’s more, should we provide said options to give ourselves control over the likelihood of an exceptional outcome? If you answered “yes” to both questions, I have great news for you. This issue is chock full of choices!


For the past three decades, the tools in our refractive surgery toolbox have most commonly been LASIK and photorefractive keratectomy. Other keratorefractive options for the treatment of refractive errors include radial keratotomy, astigmatic keratotomy, automated lamellar keratoplasty, laser thermal keratoplasty, conductive keratoplasty, and intracorneal segment ring implantation. Now, imagine you’re a patient interested in achieving better vision. As most patients do nowadays, you go online. You narrow down your search to two doctors: One offers all the above; the other offers all the above, and SMILE, highlighting the fact that it’s a new and effective procedure with a small incision approach. Which doctor would you choose? Asked another way, which doctor provides more choices?

SMILE, available in the United States since 2017, looks to be a fixture of our future, given both its characteristics and the fact that several companies are in the process of developing advanced lenticular extraction techniques. With that in mind, this issue includes not one, but two pieces on SMILE: “Bringing a Smile to LASIK Patients,” penned by Audrey Talley Rostov, MD (p.10), and a “Research Spotlight” column on the low-energy laser technique (p.33), written by D. Rex Hamilton, MD.

Additional Options

In following suit with the theme of options, Drs. Mitchell C. Shultz and Abraham Chorbajian detail the IOLs that have become available within the last year in “Selecting an IOL” (p.12), giving patients more options and ophthalmologists the ability to match the IOL with our patients’ needs.

Similarly, in “Optimizing Vision in Keratoconus Patients (p.21),” Elise Kramer, OD, FAAO, FSLS, FBCLA, describes the current options available to help these patients achieve optimal vision. In Dr. Nandini Venkateswaran’s piece, “Paving the Way for Successful DMEK (p.25),” she, in part, details the associated surgical techniques — more options for stellar patient care.

Additionally, in Dr. A. John Kanellopoulos’ “Reviewing Innovations in Corneal Cross-linking for Ectasia (p.33),” we get to see the fruits of our labor based on past options.

Aaron R. Kaufman, MD, and Roberto Pineda, MD, astutely illustrate that choice isn’t just about surgical and treatment options, it’s also about patient candidacy, in “Choosing Candidates for Topography-Guided Laser Vision Correction (p.18).”

Finally, in “Providing Drug Delivery Options for Common Corneal Conditions (p.30),” written by Drs. Wissam Farhat and Joseph Ciolino, we are reminded of the options patients have to overcome whatever hurdles prevent their adherence to our prescribed treatments.

As you can see, this issue offers many options to enable you to provide exceptional patient care and, in turn, sustain and grow your practice. Enjoy! CP