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Ethical issues with cataract surgery in patients with macular degeneration. A graduating resident’s view poin

Keywords: cataract , macular degeneration , physician-patient relation , psychosocial approach

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Abstract:

Modern cataract surgery is considered to be a successful procedure, with a low complication rate. During cataract surgery, a patient's cloudy natural lens is removed and replaced with an artificial intraocular lens implant to restore the lens's transparency. The goal of cataract surgery is to achieve improvement in visual acuity necessary to help the patient with activities of daily living and improve the quality of their life. Macular degeneration is a multifactorial syndrome with different causative factors that results in a loss of vision in the center of the visual field (the macula) because of damage to the retina, being a major cause of blindness in the elderly over 50 years in the western world. Macular degeneration can make it difficult or impossible to read or recognize faces, although enough peripheral vision remains to allow the development of other everyday activities. It occurs in “dry” and “wet” forms. The decision to perform cataract surgery in patients with macular degeneration presents with ethical issues and dilemmas for the surgeons involved in the care of the patient with posterior segment problems like macular degeneration. Good doctor-patient communication is essential to get the most benefit from the ophthalmologist, who provides care that is scientific, considerate, and compassionate. The ophthalmologist should serve as the patient’s advocate, marshaling his resources for the patient’s benefit, to maintain the quality of patient life. A biopsychosocial approach is philosophically very close to a systemic view and the development of adequate communication skills is now an aim of training programs, because a good medical care should be a partnership between patient and doctor

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