Change. Webster's defines change as … ah, forget it. Every time I look it up there's a new definition anyway.

In the monthly search for the meaning of life, at least as it's defined within these pages, a common theme that suffuses this issue is change. That shouldn't surprise, but it does. Every year, it seems I take the cataract surgery issue for granted. After all, what new can the "perfected" surgery offer? But every year it seems to be just as active and debate-filled and lively as the sexier areas of ophthalmology like refractive surgery and—who'd have thought?—retina.

Change in this context may not be  of the sudden, sweeping variety, but then, that type is probably the exception.

Eight years ago, 72 percent of cataract surgeons we surveyed were using scleral incisions. One surgeon, clearly in step with his peers, told us, "I see few, if any, advances to clear corneal incisions over my current method." Just 10 percent of his colleagues were choosing clear cornea, and just 6 percent predicted they'd be making the switch.

Today, clear cornea predominates and those choosing the sclera tally just 13 percent.

Few of us embrace change solely for its own sake. Nor, in most cases, should we. We need to see real promise of achieving benefits over what we're doing today.

There are several articles in our  Cover Focus that challenge the status quo of cataract surgery. How you judge the risk/ reward ratio will determine whether any of the ideas proposed eventually achieve the mainstream acceptance of clear-corneal incisions and notions that once occupied the margins. Futurist author Alvin Toffler has said, "The illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn and relearn."

Sometimes we learn something new; sometimes we reaffirm what we knew. But clearly, there is little about cataract surgery that doesn't warrant reexamination.

Another change, years in the making, is coming to fruition at the FDA this spring, a change that could have little noticed but important impact on new product development in ophthalmology. We're fortunate to have Mary Chatterton, of Schepens Eye Institute, share her perspective on what those changes may mean in a Guest Editorial.

Here's to change, and renewal. And go in peace, Hunter S. Thompson.