CATARACT, REFRACTIVE SURGERY , AI AND ETHICS

The ethical side of practicing medicine without harming the patient's health has always been a top issue. Our specialty includes automation and non-human intervention. Questions that arise: Is the patient aware of the nature of the operation? Is the indicated treatment, duration, and effects in the third age? Where our specialty is going?

This work was conceived and completed in the 1st Ohthalmologic University Clinic of the AHEPA Hospital, Thessaloniki

The evolution of Ophthalmic Practice in conjunction with Artificial Intelligence raises many questions concerning ethical dilemmas. 

The future of cataract and refractive surgery holds great promise due to advancements in technology and techniques, but it also presents ongoing ethical challenges that need careful consideration.

In cataracts is, most surgeon's surgical task to remove the opacified lens. The surgeon has absolute responsibility for the completion of the operation. Soon his role will be more limited. 

 Today, most of the procedure in refractive surgery is based on programmed guidance, and the surgeon has the leading role. With the fast evolution of refractive surgery, the role of the doctor will be limited, and shortly, it will disappear, and the procedure will be supervised by a technician.

Surgeons are ethically obligated to ensure patients are fully informed about the risks, benefits, and limitations of refractive surgery. This includes discussing potential complications, the likelihood of achieving the desired outcome, and alternative treatment options.

Robotics currently has limited use in cataract surgery. The surgeon has absolute responsibility for the completion of the operation. But soon, his role will be more limited. The accuracy of the measurements and previous refractive surgery are critical points of investigation and careful preparation. The evolution of machines, surgical instruments, viscoelastic surgical agents, and AI will allow more automation in surgical procedures. Besides these, new technology for implanted lenses will improve the flexibility of human vision. 

 In refractive surgery, however, robotic surgery already has a significant role. Very soon, the operation will not be performed by a surgeon's hand but by the machine. The operator will not be a surgeon but a medical technician. There will be a responsible doctor in case of complications, but with what experience?

Ethics in cataract and especially in refractive surgery encompasses a variety of considerations focused on respect for patient autonomy, commitment to informed consent, equitable access to care, and professional integrity. Practitioners must remain vigilant in these areas to uphold ethical standards and ensure patient safety and satisfaction. At this moment our procedures and the care of the patient are in the most highest standards. The question remains for the future : Who will perform the operation? Human or machine?