We have just finished our annual conference in Brighton 28-29th September 2012. It was a fantastic opportunity to speak to like-minded surgeons from all over the world in an informal environment. As always small improvements to surgical techniques were exchanged and assimilated. Advances in medicine generally proceed slowly and incrementally but their accumulation over time make a massive difference to patient outcomes. This was reflected in the a memorial lecture to Eric Arnott who died in 2011. He was the first surgeon to undertake phacoemulsification (the procedure which revolutionised cataract surgery) in the UK and Europe. He started this in the early 70’s but it didnt take off until all the fine details had been carefully worked out over the next 2 decades. I don’t think advances like phacoemulsification will take so long to get mainstream acceptance now, but the little nuances still need working out before we jump on the bandwagon of seemingly wonderful new advances such as femtosecond cataract surgery.