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Differences in Retinal Surgery Innovation Between the United States and European Union: Why We Do Things Differently

Significant differences exist between the practice patterns of retina surgeons in the United States (US) and the European Union (EU).1 Like much of medicine, many of the differences stem from learned precedents that are often distinctly regional in flavor. Other preferences are rooted in different institutional structures or reimbursement incentives. But one of the most important factors that guides the regional practice of retina surgery is the tools the physician has at his or her disposal. The regulatory bodies that approve such tools hold a large sway over the current state of medical practice, including how quickly those practice patterns change as new innovations develop. The different approaches of the United States and European Union regulatory bodies influence the over-arching environment of innovation, and the adaptability and speed with which new innovations are implemented. In this review, we focus on the differences between retina surgery in the United States and European Union. We will highlight differences that simply represent preferences, but also focus on the broad differences in approval processes between the United States and European Union, and how those differences affect the practice patterns of retina surgeons worldwide. Examining these distinctions, and the factors that influence the innovations behind these practices, will foster discussion about how one might improve or alter these disparities. Here we will start by highlighting the differences in the approval processes of the United States and European