Cathleen McCabe, MD, and Brent Saunders, chairman and CEO of Bausch + Lomb, join the podcast to break down details of the recent voluntary recall of enVista Aspire, enVista Envy, and certain enVista monofocal IOLs. Hosts Blake Williamson, MD, MPH, and Gary Wörtz, MD, invite discussion on how the Bausch + Lomb team identified an issue, prioritized patient safety, and dove into the data to bring this innovative technology back to patients as quickly and safely as possible.

John Berdahl, MD, joins Blake Williamson, MD, MPH, and Gary Wörtz, MD, to share insights into the journey of turning an idea into a product. Dr. Berdahl highlights his experience with the research and development of pressure-equalizing goggles, a nonsurgical, nonpharmacological treatment to lower IOP by creating a small vacuum to relieve pressure on the optic nerve. He describes the positives and negatives of the journey to launch a product, including funding, FDA trials, and beyond.

Blake Williamson, MD, MPH, and Gary Wörtz, MD, invite Inder Paul Singh, MD, to the podcast to discuss the technology and innovation he uses in his practice, focusing on laser floater removal. Dr. Singh reviews 1-Step vitreous removal technology (Vista Ophthalmics) for treating symptomatic floaters and how it has revolutionized his practice and provided great outcomes for his patients. He also reviews experiences with MIGS technologies that have improved his practice. 

William Wiley, MD, joins Blake Williamson, MD, MPH, and Gary Wörtz, MD, to share his early experience with the VisuMax 800 (Carl Zeiss Meditec) for SMILE. The three surgeons also share experiences with other technologies and highlight the importance of embracing the learning curve to lead the way as an early adopter in ophthalmology. 

Blake Williamson, MD, MPH, and Gary Wörtz, MD, invite William Plauché, MD, to review a presentation he recently delivered at the Caribbean Eye Meeting about his experience with PanOptix (Alcon), enVista Envy (Bausch + Lomb), and Tecnis Odyssey (Johnson & Johnson Vision) IOLs. The presentation compared similar amounts of patients and determined nuances between the three different kinds of lenses. Dr. Plauché also shares his experiences and his process for IOL selection.

This year, the theme of our podcast will feature discussions of foundational equipment and emerging technology in ophthalmology. In the first episode of 2025, Roger Zaldivar, MD, MBA, joins Gary Wörtz, MD, to discuss the ICL Guru project and how its complex algorithm integrates with ultrasound biomicroscopy platforms. Dr. Zaldivar shares his experience with ICL surgery, and how he leveraged that expertise to help improve sizing methodology and patient selection.

Rounding out this season’s theme of ‘Surgical Horror Stories,’ Jeffrey Whitsett, MD, joins Blake Williamson, MD, MPH, and Gary Wörtz, MD, to discuss his approach to managing the disappointment of poor surgical outcomes. He also shares a case example in which he encountered a complication during combination MIGS and cataract surgery, which resulted in a significant vitreous hemorrhage.. Drs. Whitsett, Williamson, and Wörtz also review the best ways to navigate potential horror stories in the business side of building a practice.

Gary Wörtz, MD, and Blake Williamson, MD, MPH, invite Nicole Fram, MD, to share a surgical horror story in which a patient experienced light arcs, starbursts, and halos after silicone IOL implantation. Dr. Fram describes her approach to IOL exchange using a Collamer lens with a larger optic to manage the positive dysphotopsias. She reviews the complications she encountered during the procedure, including iris prolapse and iridodialysis, and describes her strategies for managing stressful surgical events.

For the Halloween episode of this season’s surgical horror stories, Cathleen McCabe, MD, joins Gary Wörtz, MD, and Blake Williamson, MD, MPH, to share two uniquely challenging cases. In the first case, Dr. McCabe describes the time she performed cataract surgery on a kyphotic patient who was unable to lie on his back for the procedure. She explains her approach to positioning the patient and how she managed an additional unexpected complication. In the second story, Dr. McCabe discusses a patient with a difficult psychological history.

Sebastian Heersink, MD, joins to contribute to this season’s theme of surgical horror stories. He talks with Blake Williamson, MD, MPH, and Gary Wörtz, MD, about his experience performing cataract surgery on his father and former guest of the podcast, Marnix Heersink, MD. Dr. Sebastian Heersink recounts how he managed the stress of operating on a family member, and how he approached a less-than-perfect result when the lens was slightly decentered on postop day 1, avoiding a potential horror story. He also discusses how he calms unhappy patients by validating their concerns and putting them at ease before surgery.

Arsham Sheybani, MD, joins the podcast to continue this season’s theme of surgical horror stories. He shares a case example with Blake Williamson, MD, MPH, and Gary Wörtz, MD, in which he performed lensectomy in the eye of a 60-year-old woman who presented with angle-closure glaucoma and very high IOP. Following routine phacoemulsification, the anterior chamber began to shallow, eventually resulting in suprachoroidal hemorrhage. Dr. Sheybani also shares advice for communicating with patients about difficult, unfortunate outcomes.

Continuing this season’s theme of surgical horror stories, Neda Shamie, MD, joins Gary Wörtz, MD, to share an experience from early in her career when she faced an unexpected complication. While performing penetrating keratoplasty on a well-known patient, Dr. Shamie encountered an expulsive hemorrhage. She highlights the value of mentorship in these situations and having a trusted colleague to help shape one’s approach to stressful complications during surgery. She also emphasizes the importance of learning from these situations and gaining new surgical skills.

William Trattler, MD, joins Blake Williamson, MD, MPH, and Gary Wörtz, MD, to share a story in which a referring optometrist’s family member presented with dark brunescent cataracts in both eyes. He describes his initial approach and technique for managing these advanced cataracts, including the unexpected complication of a dropped lens and capsular bag tear in the first eye. Weeks after referring the patient to a retina specialist for an eventual good outcome, Dr. Trattler began surgery on the second eye, only to encounter a similar complication.

Paul Walton, MD, continues the discussion with Blake Williamson, MD, MPH, and Gary Wörtz, MD, on approaches to anesthesia and nuances to manage potentially difficult patients during cataract and refractive surgery. Dr. Walton shares pearls to ensure a smooth day in the operating room, mitigating potential ophthalmology ‘horror stories.’

Paul Walton, MD, joins Blake Williamson, MD, MPH, and Gary Wörtz, MD, to share concepts to help cataract and refractive surgeons avoid horror stories in the OR. He says the goal should always be to have a “boring” day, emphasizing the importance of communication and understanding with patients. The surgeons also detail their approaches to anesthesia and how to best comfort patients before, during, or after surgery.

Nathan M. Radcliffe, MD, joins Blake Williamson, MD, MPH, and Gary Wörtz, MD, to share his experiences managing complex patients with advanced-stage glaucoma. He shares a specific case of an 83-year-old man with a cataract and exfoliation glaucoma with an IOP of 56 mm Hg. Dr. Radcliffe walks through how he managed complications he encountered during the combined cataract and glaucoma surgery, including vitreous prolapse and suprachoroidal hemorrhage. The surgeons also discuss how to educate and counsel patients with advanced-stage disease to help them understand realistic surgical outcomes.

John Doane, MD, joins Blake Williamson, MD, MPH, and Gary Wörtz, MD, to share his experiences for this season’s theme of “Horror Stories” in cataract and refractive surgery. Dr. Doane reviews a few examples from his career in which he had to manage uniquely challenging situations and discusses what he learned from them. Listen to gain insights into his experiences using early surgical technology and how he approached challenges with observers fainting in the OR.

Blake Williamson, MD, MPH, and Gary Wörtz, MD, kick off the latest season of Ophthalmology off the Grid. This season focuses on the subject of ‘Horror Stories,’ where surgeons will highlight their toughest, most complicated surgical cases and how they managed them. In this episode, Drs. Williamson and Wörtz start the discussion by sharing their own uniquely challenging cases. Learn how Dr. Williamson managed an inflammatory complication following ICL implantation, and how Dr. Wörtz approached a challenging case of suspected horror fusionis.

Blake Williamson, MD, MPH, and Gary Wörtz, MD, invite Matt Jensen to round out the year of episodes dedicated to building a business and brand in ophthalmology. Jensen shares insights he gained early in his marketing career, highlighting how he adapted to variabilities in different markets and learned to grow the business at home. The trio also discusses the value of having strong, trusted partners in business when expanding into new markets, and Jensen emphasizes the importance of maintaining a consistent company culture during that expansion. To learn more about Matt Jensen's expertise, visit https://mattjensenmarketing.com/ or https://matt-jensen.com/.

Cathleen McCabe, MD, joins Blake Williamson, MD, MPH, and Gary Wörtz, MD, to discuss the challenges of moving across the country from an existing practice and referral network and starting in a new state. She shares insights into the dynamics of changing ownership and having a clear outline for the type of practice to join. Drs. McCabe, Williamson, and Wörtz further discuss the pros and cons of different business models and pearls for making decisions and taking risks with business in ophthalmology.