Foreword

Cataract surgery accompanied with implantation of an intraocular lens implant remains the most commonly performed surgery in the field of ophthalmology. It is estimated that over 18,000,000 cataract surgeries are performed each year in the world. Perhaps even more amazing, experts in the public health field tell us that in spite of this large number of cataract surgeries, every year more people suffer from visual and functional handicap secondary to cataract. In the advanced countries, approximately 8 per 1000 population undergo cataract surgery each year, and in the USA where surgeons and health care resources are widely available, the number is 10 per thousand. If these are the ideal numbers in a world with unlimited resources, we should be doing 50,000,000 cataract surgeries per year, or 2.5 times the number currently performed. In most cases, an intraocular lens is implanted, today usually a posterior chamber IOL. We are all aware that intraocular lens implantation began with Sir Harold Ridley’s first surgery on November 29, 1949, and that this brilliant innovator started with and persisted throughout his decades of innovation in implanting intraocular lens implants exclusively in the posterior chamber after extracapsular cataract extraction. History has confirmed the wisdom of this preference. Intraocular Lens Implant Surgery, while at a high state of development, continues to evolve as a combination of innovative surgeons and a well capitalized supporting industry work their magic through the innovation cycle. Their remain many unmet needs in the field of intraocular lens implantation. With growing demand in the face of reduced healthcare financial resources, we need in many parts of the world more efficient and economical models of surgery. Even in advanced countries, the variability of outcome one surgeon and one patient to another is a concern, and should respond to improved technology and education. At the cutting edge, specialized intraocular lens implants customized to the needs and desires of a small cohorts of patients are being developed and utilized. In the future, we can imagine a single lens implant customized to the needs, optics and ocular anatomy of the individual patient. These new and unique intraocular lens implants are the subject of this fascinating new book on “Premium and Specialized Intraocular Lenses’ edited by Guy Kleinmann, Ehud I. Assia and the late David J. Apple. In this book we are treated to an introductory chapter on ‘The Evolution of Intraocular Lenses” that was likely one of my friends David Apple’s last works to be published. For me, this chapter alone makes the book worthy of acquiring, as it is a priceless summary by Dr. Apple and two of his close colleagues regarding his thoughts near the end of his extraordinary career. Following this fascinating and historical summary are Chapters on Accommodating IOL’s, Telescopic IOL’s, Supplementary IOL’s, Full Size IOL’s, and Iris Prosthesis. The authors selected are experienced and knowledgeable. Each of the Chapters is well written, illustrated and full of cutting edge information and clinical pearls not easily accessed in any other source. The book is an easy read, and I learned many clinically useful details regarding these specialized IOL’s. I recommend this book to the cataract surgeon who wishes to stay current with the newest emerging technologies in the intraocular lens and iris implantation field. I thank the editors for a well written, concise and clinically useful summary of the state of the art, and for another opportunity to learn from my much missed friend and colleague David J. Apple.