Som strives to provide a bespoke solution to meet the requirements of each patient, as a one-size-fits-all solution may not offer optimum outcome for the individuals needs. “My aim is to deliver a personalised service to my patients, distilled from the best technologies, services and practice available worldwide”.
He will discuss all options, often with the help of diagrams and computer animations to help you understand and choose the solutions which are best for you personally. “I aim to support and look after my patients personally throughout their care from start to finish.”
He is based at Spire Murrayfield Hospital, Wirral, and at Arrowe Park Hospital, Wirral. Both centres are equipped with state-of the-art technology suitable for diagnostics and a wide spectrum of eye surgery.
He specialises in micro-incision cataract surgery and management of complex cases. He has a long standing interest and expertise in the development and refinement of new surgical techniques. As a result, he can offer patients the most up to date procedures. He has designed instruments for complex cataract and other anterior segment (front of the eye) surgery and is an early adopter of technologies for retinal surgery. He is one of the most experienced surgeons in the UK using sutureless 25 gauge technique for vitrectomy procedures (retinal detachments, macular holes and other indications) having used this for over 70% of vitrectomy procedures since introduction in 2003. This greatly enhances the speed of recovery and comfort after retinal surgery.
Som has been a consultant on the Wirral since 2001. He initially trained in India at the University of Calcutta (now Kolkata), followed by further specialist training in the UK in a range of units including Dorchester, Oxford, Wirral & Sheffield .
He is internationally recognised as a leading cataract and retinal surgeon. He is regularly a member of the faculty at major professional meetings such as The American Academy of Ophthalmology, The United Kingdom & Ireland Society for Cataract & Refractive Surgery (also serves on the governing board of this body), The European Society of Cataract & Refractive Surgeons and The American Society of Cataract & Refractive Surgery. He has over 70 publications and 100 presentations to his credit. In 2008 he was conferred a Fellowship of the American College Surgeons and an achievement award from the American Academy of Ophthalmology in recognition of his contribution to the profession. He is an examiner for UK Royal Colleges and on the faculty of the Microsurgical Training course of The Royal College of Ophthalmologists. He is a member of the Scientific Committee of the Royal College of Ophthalmologists and is program chair for the first retinal speciality meeting being organised by the Royal College of Ophthalmologists in May 2010.
Cataract surgery
‘Cataract surgery is the most widely performed operation worldwide,’ says Som. However, there are wide variations in the approach to this procedure. While all surgeons aim to improve the patient’s vision, some go further and are able to offer solutions to suit the individual that include the possibility of being independent of spectacles for most tasks after surgery. ‘The key is choice,’ says Som. ‘For example, while the majority of patients do very well with a topical anaesthetic (drops only), a full range of anaesthetic techniques is available, including a local anaesthetic block (an injection into the tissue around the eye) administered by a consultant anaesthetist who is highly skilled in ophthalmic anaesthesia or general anaesthesia (being asleep). While most patients will prefer the advantages of minimal intervention and instantaneous recovery offered by the drops-only technique some, who are more anxious, may prefer to be asleep,’ explains Som.
Modern technology has made it possible to choose an intraocular lens (IOL) implant that matches the aim of the patient. Thus, implants can be chosen to achieve good vision at distance or near, or to address pre-existing astigmatism using toric lenses. Som has great experience on using multifocal, accommodating and toric implants. He has published key papers on multifocal IOL use and acted as specialist adviser to NICE (the National Institute for Health and Clinical Excellence) on multifocal IOLs.
Cataract surgery is routinely done in the practice using micro-incision technology. The incisions are less than 2mm in size (about the thickness of a 10p piece), allowing very rapid recovery and excellent visual outcomes.
Refractive lens surgery
‘The highly successful techniques of modern cataract surgery can be applied to correct near sightedness and far-sightedness. This procedure is also called Prelex (presbyopic lens exchange),’ says Som. ‘Multifocal intraocular lens implants are often used. Prelex may be the procedure of choice for those candidates who are too nearsighted, too far-sighted or have corneas that are too thin for laser refractive surgery (LASIK). Patients who are not suitable for LASIK may be candidates for refractive lens surgery. It is also a viable alternative for those who wish to eliminate their dependence on traditional or progressive bifocals or varifocals and those who may be showing signs (even without symptoms) of developing cataracts.’
Retinal surgery
‘Retinal surgery is required for a host of conditions such as retinal detachments, macular holes, epiretinal membranes etc. Some of these present with a gradual decrease or distortion of central vision, while others arise more rapidly.’ says Som. ‘Until recently, this was seen to be a major procedure with many potential side effects. The introduction of new technologies allows most retinal surgery to be done through self-sealing, minute tunnels, so that there is minimal discomfort after the operation. Surgery can often be done as a day case and recovery is rapid.’
Macular degeneration
‘Macular degeneration is the leading cause of visual reduction in the older age groups,’ says Som. ‘Treatment was once largely ineffectual, but, in recent years, huge strides have been made and greatly improved outcomes are now possible,’ he adds. Som has an established track record of introducing macular degeneration treatments for his patients and was among the first surgeons in the UK to adopt techniques such as macular translocation, telescopic lens implants and the use of modern drugs to treat macular degeneration.