Eyes of the World
JASON S. SLAKTER, MD
It was 12 years ago that the reality of the differences between medical practice in the United States and elsewhere really hit home. I was attending an educational meeting in St. Petersburg, Russia, and was having lunch with a retinal surgeon from Bulgaria. He was proudly informing me that, in his first year in practice, he was able to perform 50 scleral buckle procedures for repair of retinal detachments. When I asked if it was typical for a new physician to see 50 or more detachments in that period of time, he corrected me by indicating he had actually seen more than 200 detachments. He explained that the reason he had only done 50 operations was because he only had 25 pieces of suture, each of which could be cut in half and used for 1 operation. Because his last piece of suture was used, he was unable to perform surgery until he was able to acquire the critically needed material. I was shocked, having come from a country where we routinely discard multiple packages of open suture material with each case. That patients could not be treated due to a lack of simple suture materials was truly an eye-opening experience.
Since that time, I have no doubt that the situation has improved in many developing countries. But without question, some of the procedures, both diagnostic and therapeutic, that we take for granted here in the United States are limited in availability elsewhere. Many of the issues that I hear discussed at local and national meetings, such as new imaging and surgical instrumentation or the relative benefits of ranibizumab (Lucentis, Genentech) vs bevacizumab (Avastin, Genentech), are moot points in countries where the resources for even the basic necessities are lacking.
EVRS GETS ON BOARD
Since its inception, Retinal Physician has attempted to be a comprehensive journal, addressing a wide range of topics confronting the retinal community throughout the world. Unfortunately, as a US-based publication, there is an inherent bias toward stories and issues that confront our local communities. As a first step in reaching out to retina specialists worldwide, we welcome the membership of the European VitreoRetinal Society (EVRS) as our newest partners in the Retinal Physician community.
In this issue, we are pleased to include a short introduction to the history of the EVRS and its role in promoting education within the European community on issues related to vitreoretinal surgery and retinal practice. We welcome their active participation in the discussions we publish, and we look forward to interactions between our communities. Going forward, we will be reaching out to other organizations throughout the world to truly encompass a more comprehensive audience. I firmly believe that, through a more global interaction among all members of the retinal community, we will achieve the best opportunities to advance our field for the benefit of our patients.