Cataract Surgeon: What constitutes a "good surgeon"

[SLMitchell]

In many posts, I have seen it suggested that one obtain the services of "a good eye surgeon" for their cataract surgery.  Please tell me what constitutes a "good eye surgeon?"  Also, is it worth the extra expense to have laser cataract surgery?   I need cataract surgery in the very near future and feel as though I am attempting to make a life-altering decision without all the facts!  Any input is greatly appreciated.

[SoftwareDeveloper]

Its the most common, and very safe, surgery out there so the odds are whoever you choose will leave you with good results. However there are of course rare complications, so it does make sense to choose the best doctor you can just to play it safe.

Often people try to ask local optometrists for their opinions since they may see patients who have been to various surgeons for followups so they may have the best sense of the results. Sometimes of course they may get co-management fees that vary by surgeon, hopefully if you've had a long time optometrist they won't let that bias them, and you can try asking more than one.

You don't say where you live (there are posters around the world, even though most are in the US) for anyone to suggest specifics. One way to attempt to find a good doctor is of course to find out what other doctors think of them. There are some groups that collect data from doctors in an area about who they would use if they or their family needed treatment. Some cities like Denver have magazines that publish the best doctors from such surveys (or it may be newspapers or TV stations I guess elsewhere), I don't know what city you are in. There is a national site BestDoctors.com which seems to unfortunately only provide the result of their surveys to people whose insurers pay for access. I did see a Denver magazine publish the listing from that site for Denver one year, I don't know if its common for local publications to pay for it.

Of course what matters most is the actual doctor rather than just the facility, but US News and World Report publishes a list of what they rate as the top eye hospitals:
http://health.usnews.com/best-hospitals/rankings/ophthalmology
.

There is an International Intraocular Implant club which only has about 300 members since they are chosen by the existing members:
http://www.iiiclub.org/

Membership would indicate respect by their peers, though it could be for clinical judgement rather than surgical technique, but since it is a simple surgery I'd lean towards judgment being important to handle whatever rare complications might arise.

  One thing you can try asking for are statistics on their results (e.g. complication rates, how close they come to hitting the refraction target, etc). They may not have those (though ideally they should be tracking such things to be trying to figure out how to improve their results). You want a high volume surgeon who has done many operations since as with any skill practice helps, especially since some complications are rare and it increases the odds they've learned how to deal with them (as to what high volume is, the issue is to compare among your options, mine had done 40,000+ surgeries, which isn't common). Ideally you want someone who is still doing lots of operations to keep their skills up (vs. say if a doctor is mostly managing the clinic and his surgeries were mostly in the past). Even an experienced manual surgeon has a learning curve with laser surgery, it sounds like 100-150 or so laser surgeries should get past that (though some studies use 50 as a cutoff).

There are two aspects of a good surgeon: good clinical judgement and good surgical technique. If the surgeon is on faculty at a medical school, or involved in say professional organizations that set care standards, that would be another clue that their peers respect their judgement.

One thing I did when seeking a surgeon abroad (to get a newer IOL not yet approved here) was to search publications targeted at cataract surgeons, and conferences, to see surgeons who were asked for quotes for articles and to give talks at conferences. That seemed at least one clue they were respected for their peers for clinical judgement, but of course says nothing about their physical surgical skill. I don't know how much screening goes on to select surgeons to do clinical trials involving surgery. However I did consider it a good sign if a surgeon was involved in IOL trials since I figured the lens companies (or the doctor organizing the trials) wouldn't want the results tainted by poor surgical technique.

[CBCT]

Castle Connolly provides a list of peer nominated Top Doctors in multiple fields of medicine.  You can search by specialty and zip code
https://www.castleconnolly.com