We did a survey recently and about 20% of our viewers indicated that they wanted more videos of novice surgeons who are still learning basic techniques of cataract surgery. Today’s video is a young surgeon who has only done about 30 cataract surgeries on his own and he is doing phaco stop-and-chop for nucleus removal.
The surgery is quite good for an ophthalmologist who is so early in the learning curve of phacoemulsification, but there are a few areas that could use refinement.
The excellent parts of the surgery are:
- good draping and patient anesthesia
- properly constructed incisions
- excellent capsulorhexis and hydro-dissection
- good ability to pivot within the incision and keep eye in primary
- stop-and-chop technique is done very well
- cortex removal is good and thorough
- IOL is loaded well and centered in capsular bag
So much of the surgery is excellent, that we have just a few suggested areas of improvement:
- since a cohesive OVD is used for the capsulorhexis, coating the corneal endothelium with dispersive OVD prior to inserting the phaco probe is recommended
- allow the IOL haptics to unfold with the eye full of OVD instead of having the cold water from the I/A probe cause the lens to become less flexible
- hydrate the incision in a linear manner at the corneal stroma to avoid having the two corners of the incision sealed while the central incision is not hydrated
This resident is sure to become a very talented surgeon and I look forward to operating with him over the course of the next year.
Click below to learn from the Beginning Surgeon Stop-and-Chop Case (16 min):
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