Three wishes: What the premium surgeon longs for today

Today’s premium surgeon is constantly challenged with achieving perfect visual outcomes in the world of refractive and refractive cataract surgery. The infamous “three wishes” joke involves a protagonist such as a genie granting three wishes, in which the first two are ideal and the third is either misinterpreted or intentionally granted in an awkward literal fashion and cannot be reversed because it is the final wish, resulting in the punchline of the joke.A perfect example: The premium surgeon is granted a new femtosecond laser with built-in aberrometry and hands-free remote capability from his or her beach chair and as a second wish is granted an IOL that is truly bionic, yielding emmetropia and the freedom of all visual correction for the patient. Unfortunately, the patient postoperatively needs psychological counseling with 20/15 vision and complains of “not seeing well.” The surgeon’s third wish is to make this patient disappear, which the genie grants, but the patient ends up on the beach chair next to the surgeon indefinitely.