When you are in residency training, you must learn the knowledge of ophthalmology and the hands-on skills such as surgery, but you also need to understand the patient experience. This video shows a very nicely performed cataract surgery by an anonymous resident. And the chop technique is great, the capsulorhexis is precise, and the work is clean. But because toothed forceps were used to fixate the eye during incision creation, the patient develops a significant sub-conjunctival hemorrhage. I know this has no effect on the patient’s visual outcome and that it will resolve in about a week or so, but it makes for a less than optimal patient experience. Hear my thoughts about the importance of the patient experience. And then tune in tomorrow for our CataractCoach PodCast #6 where we learn from Dr Vance Thompson about optimizing the patient experience.
When I do cataract surgery I dry the conjunctiva with a weck and then use my left hand forefinger for counterpressure to make my clear cornea incision. No bleeding, no pain and it gives me good control. If i have a patient who’s moving a lot during rhexis formation I fixate the eye either using 2 fingers or if not good exposure/tight orbit I place my chopper through paracentesis and it fixates the eye with the left hand as I tear with the right.