1. What surgical cases do you find most enjoyable to
perform and rewarding once successfully completed?
I am trained in vitreoretinal and anterior segment surgery.
Combined surgical procedures, such as modern phacoemulsification
and IOL implantation with simultaneous
pars plana vitrectomy, are, for me, the most rewarding procedures
to perform. They provide patients with rapid visual
rehabilitation and give surgeons insight into the interactions
and connections between the anterior and posterior segments.
Because there is less surgical trauma with small incisions
and sutureless techniques, these are
now part of my standard approach for
most macular pucker and macular hole
surgeries as well as for primary retinal
detachment repair. The ability to perform
both anterior and posterior segment surgery
is also helpful in the reconstruction
of severe trauma cases and in patients
with diabetic eye complications.
2. What technologies are essential to
your surgical technique?
Good phaco and vitrectomy machines
are the basis of my surgical technique. I use high-speed cutters
for vitrectomy and 2-mm small incisions for cataract
surgery. My standard size for simple vitrectomy is 23-gauge.
I reserve 20-gauge instrumentation for complex cases such
as advanced proliferative vitreoretinopathy and trauma. In
this surgical scenario, both hands are used for vitrectomy,
and a fourth sclerotomy is created for an additional light
source. I use angled subretinal instrumentation when needed.
I always suture the sclerotomies if a silicone oil tamponade
is necessary because I want to avoid subconjunctival
silicone efflux in the postoperative course.
3. What challenges have you had to overcome being a
woman in a male-dominated profession?
At the time when I started performing microsurgery at the
University Clinic in Vienna in 1974-1975, surgery was reserved
for men. The woman's role in the operating room was to
patiently assist the surgeon. I was determined to defy these
boundaries and become a surgeon. Fortunately, during medical
school I had a professor who had four daughters and was
willing to let me try. I did many intracapsular cataract surgery
cases with the Graefe knife. My colleagues scrutinized and
commented on my surgeries, and this motivated me to prepare
the best I could for every case. I performed a lot of
Friday afternoon cases, but I never refused one case because I
gained more experience. At that time, vitreous surgery was
not well known in Austria. Buckle procedures for retinal
detachment cases were routine. I persevered, and finally, in
1979, Ronald G. Michels, MD, invited me to Johns Hopkins
University in Baltimore to study vitreous surgery. In 1980, I
spent some time at Duke University in Durham, NC, with
Robert Machemer, MD, finishing my thesis on proliferative
vitreoretinopathy. Coming back from the United States, I
continued my work in Vienna. I had to work and write on my
own for a long time while male colleagues worked in groups.
4. What are your responsibilities as
Secretary of the Austrian
Ophthalmological Society, and how has
this leadership role had an impact on
your career?
I am happy to be the Secretary of the
Austrian Ophthalmic Society after serving
4 years as the organization's President. Every
year we organize a national meeting, and
the Secretary is responsible for the program.
I have also been the Editor-in-Chief of
the Austrian ophthalmic journal, the
Spektrum für Augenheilkunde, for more than 8 years. Both
functions give me the opportunity to help young ophthalmologists
during their training and to find new talent. Also,
through these roles I build international connections. I was
invited to be an examiner for the European Board of
Ophthalmology, and I am now responsible for the Retina
Program for the European Society of Ophthalmology. I am a
member of the board of trustees of the International
Council of Ophthalmology. The Austrian society works
closely with the American Academy of Ophthalmology to
promote the importance of ophthalmology in medicine and
to strengthen the position of ophthalmologists. I have introduced
an Austrian Association for Research in Vision and
Ophthalmology Day (AARVO) at our national meeting, a
project initiated by Martine Jager, MD, PhD, the 2008
President of ARVO.
5. If you were not an ophthalmologist, what profession
would you pursue?
If we did not age, I would have become a dancer
because I love movement and music. If I were part of an
orchestra, I would want to be the conductor because I
never fear responsibility. But, these dreams aside, I would
study medicine again, and I am convinced that ophthalmology
is one of its finest branches.