Diary of a cataract surgeon in the year 2045

My first patient of the day is a recently retired 80-year-old woman who had been using topical antioxidants for the last 10 years to delay lens opacification,1-8 but she was recently required by police to take an eyesight test having driven into the exit lane of a tunnel. She passed the acuity test but did not meet the ocular straylight and contrast sensitivity standards and therefore she is obliged to undergo cataract surgery.

We discuss various options and in the end she chooses the budget option of a bag-in-the-lens multifocal IOL. I explain to her that the corneal incisions, the anterior and posterior capsulotomies and the nucleus chop will be done by an optometrist operating a femtosecond laser and that I will then step in to do the lens removal and IOL implantation. She asks if the implant can be replaced if she does not have perfect vision postoperatively. I explain that the power of IOL required will be calculated based on readings taken during surgery and the IOL will then be 3D printed9 and sterilised before being implanted so the likelihood of her having less-than-perfect vision is minimal.