Bimanual Dexterity Improves Ocular Surgery

I tell my first-year ophthalmology residents to start doing daily tasks such as eating food, shaving, and brushing teeth with their non-dominant hands. It also extends to computer use by switching the mouse to the opposite site of the keyboard and sometimes even holding a pen in the non-dominant hand. Initially, it is not easy and some people feel like giving up and just taking the easy path of sticking with the dominant hand. But this is a mistake for those who intend to have a career as ophthalmic surgeons.

Studies have shown that using the non-dominant hand in daily tasks actually does translate to better dexterity in that hand, specifically in surgeons. For ophthalmologists, it is even more critical. Think of a retinal surgeon doing a pars plana vitrectomy to repair a retinal detachment: to access all parts of the retina, it is crucial that the surgeon be able to switch hands. The vitrector should feel equally comfortable in either the left or right hands. There is simply no other way to have complete access to the entire vitreous cavity.

For cataract surgery as well, right handed surgeons tend to hold the phaco probe in the right hand which means that the chopper is used in the left hand. But watch a phaco chop cataract surgery video and you’ll notice that most of the work and movement is with the chopper, while the phaco probe is relatively still in the center of the anterior segment.

Once you are comfortable doing all daily tasks with your non-dominant hands, slowly bring that to the operating room. The video below is an excerpt from a recent cataract surgery where I switched hands and operated as a left-handed surgeon would. The case went great and it was just about the same as if I had done it right-handed. Ophthalmic surgeons must have great bimanual dexterity.

And if you’re one of my residents, when we have a meal together, I will be watching to make sure that you’re eating with your non-dominant hand. Since Los Angeles is such a diverse city with all kinds of cuisine, I’ll probably take the group to a restaurant where chopsticks are required. And if you’re really feeling competitive, challenge me to see who is better at using chopsticks in both hands simultaneously or writing with both hands simultaneously!

Click below for the video clip of cataract surgery performed left handed:

(Note: I can only write the same sentence with both hands simultaneously — I cannot write two different things at the same time. Well, at least not yet.)