1020: Playlist: Complications

Complications happen to all surgeons, no matter how much experience we have. It is true that a surgeon who has done only a few hundred cataract surgeries will have a much higher complication rate than a surgeon who has done 10,000 surgeries. But even truly world-class master surgeons who are experts at cataract surgery will still encounter complications. The patient’s tissue is a strong variable that can change the outcome of the surgery. The result of surgery is a combination of your surgery plus the patient’s tissue response and healing.

The complication can either be seen as a mistake or a lesson — the difference is that you learn from thie lesson. It has been said that a smart surgeon will learn from his/her complications, while a truly wise surgeon will learn from the complications of others. These videos give you the opportunity for the latter. We can learn from this videos and increase our awareness of potential issues that can arise during cataract surgery. And then we can learn how to recognize, react, and then recover from this complications.

A phaco wound burn can happen at any time to any surgeon. The ultrasonic vibrations of the phaco needle create heat via friction and if we are not careful, this can quickly burn the delicate corneal stroma.
A poorly constructed incision will lead to even more trouble such as iris prolapse and a greater risk of iatrogenic damage. This video shows how quickly things can go south.
When you have a complication such as a posterior capsule rupture, you must be able to recover from it. This video shows what happens when you do not know how to deal with your complication.
The hole punch sign is important to recognize because it often indicates that the posterior capsule has already been ruptured. Catching this early means a better outcome for the patient.

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