1335: behind the scenes: inside my OR

Surgeons from around the world frequently email me asking to come visit my operating room to watch surgery. In the OR, an observer would only be able to see a limited amount — just the view of the room and the video monitor showing the microscope view. You can see the room view in this video and the microscope view is what we normally share here on CataractCoach.

Our standards for cataract surgery are very high — this is the highest level of care and it is exactly how I would want surgery done on my own eyes. The staff members are excellent and they work at a relaxed but efficient pace. The total time to clean the room, set up everything, do the time-out, prep & drape the patient, complete the surgery, and then prepare for the next case is about 15 minutes. This is about the same pace as previous posts about cycle time that we featured here in the past. In the morning shown here, we completed 10 cataract cases by 9:30am with a start time of 6:30am, and that included two complex cases which required more time. Again, remember that it is not about speed — but rather being in the state of flow where efficiency is natural. Tomorrow I will post the microscope view of the the actual surgery shown here.

Watch this video and you can see exactly what happens in my OR before, during, and after surgery:

link here


  1. Uday, good video, really enjoy your videos. My only comment is why do you use tetracaine, instead of proxymetacaine or oxybuprocaine (benoxinate)? Tetracaine in my hands causes clouding of the corneal epithelium, which can be such a problem, should the surgery be prolonged? I have had to scrape the corneal epithelium on one or two occasions, while supervising a trainee, who had run into complications. Same as using betadine 10% instead of 5%? I tend to value clarity of the cornea so very much, that immediately after inserting the speculum, I apply HPMC and have never worried about corneal clarity. Proxymetacaine with intracameral unpreserved lignocaine works so well for me. Just an observation..I am a consultant ophthalmologist, at the Dorset County Hospital, Dorset, Southwest England in the United Kingdom; primarily an oculoplastics and paediatric and neuroophthalmologist, but do high volume cataract surgery 22 phacos on a Saturday and 20 on a Sunday two weekends per month.

    1. sounds like you have a good system that works well in your hands. Same with me — just a tad different. Every chef has his own way of cooking the same meal. Same with cataract surgeons. I would like to feature one of your videos — please submit one.

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