Yesterday’s video was a complete toric IOL case from marking to alignment, however the IOL was loaded by the technician so that was not seen on the video. Today we will show you a toric case with a surgeon-loaded IOL.
This is a routine phaco chop case with a planned toric IOL. However, the surgical scrub tech who is working with me is unsure about how to load the IOL. She has only been trained on the pre-loaded non-toric version of this acrylic, monofocal IOL, so she has asked me to load the lens and teach her.
You can certainly learn from the phaco chop technique shown here — the entire case looks great and it is only 8 minutes in total (and that includes the time spent loading the IOL). It is very important for the surgeon to know how to set-up the phaco machine, load the IOL, and do every step of the procedure.
The surgeon must know how to do the surgery, but also the job of the scrub tech and the nursing staff as well!
If you get called in the middle of the night into the emergency department to help a patient with a corneal laceration and puncture of the anterior lens capsule, you may need to set up the phaco machine yourself. The night crew of the hospital and operating room may not be familiar with cataract surgery which is primarily done in the day as an elective case.
If you are a surgeon-in-training such as a resident or registrar, you must know how to load the IOL yourself. When I supervise the ophthalmology residents at our teaching hospital (Olive View-UCLA Medical Center in the Los Angeles area), I require that they load the IOLs themselves. The scrub techs will not load the lens for them.
Click below to learn from this Phaco Chop case with Surgeon-Loaded Toric IOL:
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