Many of the articles and videos here at CataractCoach.com feature unusual, difficult, or challenging cataract cases. These are fun videos to watch and there is a lot of learning that is done when the key to solving a tough case is explained in detail. But what percent of our surgical cases are routine and what portion are these rare types? For most of us, routine cataract cases compromise 80% or more of our typical surgical lineup for the day. While “Challenging Cataract Cases” is my most requested presentation for live presentation at meetings, there is a pleasure in trying to perfect the routine cataract case.
There is beauty in trying to achieve perfection for each step of a routine cataract case. I’ve written many articles about something as seemingly simple as making the phaco incision. This event of making the main phaco incision takes about 1 second, but to make it just right, well-balanced, and astigmatically neutral can take hundreds of cases to refine. The same applies to the capsulorhexis: aim to make it perfectly round, centered over the visual axis, and overlapping the optic for a full 360° to securely hold the IOL.
When it comes to phaco energy, how little ultrasound can be used to remove the cataract? For fluidics, how little fluid can be pushed through the eye to remove the cataract? The goal is to make my cataract surgery better and better with every case — a concept that is often referred to as Kaizen. Even after completing 20,000 cataract surgeries there is still room for improvement especially as new technologies and new techniques are developed. As our field evolves, the way that we do cataract surgery in the future is going to be different than what we do now.
On your next surgery day, channel your inner perfectionist and try to make each and every step of the routine cataract surgeries as perfect as possible. This is my goal and I find immense happiness and beauty in trying to achieve perfection.
Click below to see a recent routine cataract surgery with my voiceover:
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