Self-Critical Analysis of Cataract Surgery

For surgeons it is important to be self-critical in oder to continually advance our surgical skills and judgment. The goal of this analysis is to see how we can make every little step of the surgery better, safer, more efficient, and more accurate. As I teach my residents, you need to be your own toughest critic. At the end of each case, ask yourself what could have been done better and resolve to get better with every surgery.

“Experience is the name we give to our mistakes” – Oscar Wilde

It is important that you also record videos of your surgery for self-learning. It’s the same as athletes reviewing game-day footage to assess their performance. You want to learn from every case, particularly early in the learning curve of cataract surgery. I try to record most surgeries that I do, but I tend not to save most of the videos — just the interesting ones. As you progress in your skills, more and more cases become routine and there are fewer challenges.

To a novice surgeon, the video below looks like an amazing case that is done in just a few minutes. To a more experienced surgeon, the case still looks good but there are a few areas for improvement. It sounds nit-picky to analyze and dissect this surgery which was uncomplicated and resulted in excellent vision for our patient, but we want to always be in pursuit of perfection in our surgeries. In this video, I could have done the following better:

  • better draping to keep eyelashes out of the field
  • a slightly longer incision tunnel length to make it perfect
  • better hydro-dissection to facilitate cortex removal
  • keeping the eye in primary position / avoid pushing the eye to nasal canthus
  • more complete removal of viscoelastic at the end of the case

Click below to watch this video of me reviewing my own surgery and finding areas for improvement:



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