When Yao Ke, Chief of the Eye Center of the Second Affiliated Hospital of Zhejiang University School of Medicine and Zhejiang University Eye Hospital, who is also the President of Chinese Ophthalmological Society, studied in the United States and Switzerland in the 1980s, he was "shocked" by the significant technical gap in cataract surgery between China and the two countries.
According to Yao, at that time, phacoemulsification, a technique in which an ultrasonic device is used to break up and then remove a clouded lens, had been developed as an upgrade to extracapsular cataract extraction, or ECCE, for treating cataract. With the technique, ophthalmologists in the US and Switzerland could remove lens with a tiny needle in just 10 minutes. In comparison, Chinese ophthalmologists just began to use ECCE which has a bigger incision.
"I always thought how the situation could be changed and when those technologies could be applied in China," said Yao.
In 1990, Yao returned to China after completing his post-doctoral research in Switzerland. He gave up a well-paid position and excellent research environment in Switzerland because "China needs ophthalmologists" and his "future is in China".
He also made three wishes — promoting scientific development in China, setting up a mobile eye hospital to benefit more patients, and establishing a modern eye hospital.
Pioneer scientific development
Over the last more than 30 years, Yao has been committed to introducing cutting-edge technologies in China to serve the varying vision demands of patients. He practiced many "firsts" and continuously inspires the entire ophthalmology sector in the country.
In 1990, he purchased and donated a fully automatic perimeter, the first of its kind in China, to his alma mater, Zhejiang Medical University.
In 1992, he carried out the first phacoemulsification cataract surgery in China, marking a milestone in cataract treatment.
Since 2013, he has been leading his team to perform femtosecond laser-assisted cataract surgery, also known as FLACS, to improve safety, efficiency and accuracy. Now, China has become one of the leading countries in applying this advanced technology in terms of the number of operations. In 2022, despite the pandemic, the Eye Center of the Second Affiliated Hospital of Zhejiang University School of Medicine performed more than 5,200 FLACS, ranking the first in the world.
"Never be a conservative people. I always believe that keeping a curious mindset and a wish to explore new matters are keys to be a pioneer, a scholar and a doctor who can bring real benefits to patients," Yao said." I have a belief that there is no best, just better."
In recent years, Yao also pays greater attention to refractive cataract surgery and stem cells in response to the "high-quality vision" demand of patients.
According to statistics from the Chinese Ophthalmological Society, about 80 percent of senior Chinese people aged above 60 are affected by cataract, presbyopia or both. Because of the increasing life expectancy and living quality, the needs of patients have evolved from "have sight" to "have clarity from distance to intermediate to near, and day and night" in the last 10 years.
On March 9, Yao implanted the latest intraocular lens, TECNIS Synergy™ IOL (NMPA Certificated No. 20223160617), developed by Johnson & Johnson Surgical Vision, which could offer a wide range of continuous vision and a near vision as short as 33 centimeters, into eyes of a woman aged 60, marking the debut of the new product in China. The implantation could satisfy the woman's needs from moment to moment, for example, using digital devices, participating in stock exchange and driving, according to Yao.
According to Johnson & Johnson Surgical Vision, the new product was displayed at the fifth China International Import Expo in November and obtained approval from the National Medical Products Administration in December. The introduction of the intraocular lens will support the quality development of ophthalmology in China.
Bringing hope to more patients
Yao, one of four siblings to follow his father's career path as an ophthalmologist, devotes himself to help more cataract affected patients, regardless their fortune and status.
Inspired from the Orbis, a charitable international flying eye hospital, Yao established a mobile hospital named Eye Hospital On-wheel in 1996 to provide free cataract surgeries to patients in poverty areas.
Over the last 27 years, the mobile hospital, the first of its kind in China, has traveled for more than 600,000 kilometers. More than 10,000 cataract patients in China including Xinjiang Uygur Autonomous Region and Tibet autonomous region received treatments, and more than 100,000 people enjoyed free clinical services.
The mobile hospital also helps to train local ophthalmology professionals so patients could get treatment more conveniently.
"Give a man fish, he will have a meal; teach him to fish, he will have food all his life," said Yao.
"The program also gives young talent chances to experience a poor life which they could never imagine. It helps to cultivate hard working spirit among young doctors," Yao added.
In Dec 2021, led by Yao, the Zhejiang University Eye Hospital in Hangzhou of Zhejiang province, one of the biggest eye-specialized hospitals in China, began operation. In 2022, the hospital received nearly 900,000 patients and performed 113,000 operations including 27,000 cataract surgery. The third wish of Yao turned into reality.
During the 14th Five-Year Plan (2021-25), China is set to increase the cataract surgical rate, or CSR, measuring the number of procedures per million people, to 3,500 to help more people regain vision. Yao is still exploring new areas and is keen to contribute to the development of ophthalmology in China.
"As a doctor, on one hand, I will strive to help patients to prevent blindness, as it was required by the 14th Five-Year Plan; on the other hand, I will give patients choices for quality vision by keeping curious about the latest technologies," Yao said.
Yao is still guiding university students and would like to share his ideas and findings on ophthalmology.
He said China's top medical scientists must not only shoulder the progress of science and technology, but also devote themselves to the progress of society, country and humanity.
"We must promote teamwork rather than work alone," he said. "The future of China's ophthalmology belongs to young people and we must guide them well."