Learning intra-ocular surgery is not easy and it can take years just to be comfortable with just the basics. Look at this pic and see how many issues need fixing:
- The hands are not holding the instruments correctly. The right hand should be holding the phaco probe like a pen or pencil. The odd grip in the photo does not allow for fine control within the eye. The left hand is also holding the chopper in an odd manner.
- The hand position needs to be improved also. The phaco probe in the right hand should be at a less steep angle and the chopper in the left hand should be brought towards the surgeon.
- Both of these issues are causing the eye to be pushed toward the nasal canthus which means that the eye is no longer in primary. This compromises the view into the eye and makes it more difficult to operate.
These issues need to be address first, before we work on learning an advanced technique like phaco chop. You must start with the basics before progressing — like the saying goes, you must learn to walk before you learn to run.
Click below to hear the teaching points for this novice surgeon case:
I would like to see alternatives for capsulorhexis at an eye that happens not to be in primary position. Thanks!