scholarly journals Reverse order method for teaching cataract surgery to residents

2019 ◽  
Vol 4 (1) ◽  
pp. e000190
Author(s):  
Gustavo Ricci Malavazzi ◽  
Jonathan Clive Lake ◽  
Eduardo Sone Soriano ◽  
Walton Nose

ObjectiveTo implement a method to train residents in the performance of phacoemulsification surgery, with the steps completed in reverse chronological order and with the easiest step being undertaken first.Methods and analysisWe created a method for training ophthalmology residents in which we taught phacoemulsification surgery in a series of steps learnt in reverse order. Each resident advanced through the teaching modules only after being approved in the final step and then progressed to the complete performance of surgeries. We analysed the rates of complications in the 2 years after introducing the new method.ResultsThe new method allowed for a standardised approach that enabled replicated teaching of phacoemulsification regardless of instructor or student. After implementing the new method, residents performed 1817 phacoemulsification surgeries in the first year and 1860 in the second year, with posterior capsule rupture rates of 8.42% and 7.9%, respectively.ConclusionsTeaching residents to perform the steps of phacoemulsification in a standardised reverse order resulted in low rates of complications.

2020 ◽  
Vol 46 (2) ◽  
pp. 179-184
Author(s):  
D. Claire Miller ◽  
Karen L. Christopher ◽  
Jennifer L. Patnaik ◽  
Anne M. Lynch ◽  
Leonard K. Seibold ◽  
...  

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Yu Jeong Kim ◽  
Su Jin Park ◽  
Jong Yeon Lee ◽  
Dae Yeong Lee ◽  
Dong Heun Nam

Purpose. To evaluate intraoperative complications and utilization of adjunctive devices between microscope and intracameral illuminations during cataract surgery in the elderly over 75 years. Design. A retrospective, consecutive, interventional case series Participants. Two hundred eighty-six eyes of 184 patients older than 75 years who underwent cataract surgery using microscope and intracameral illuminations. Methods. A chart review was performed on an advanced cataract surgery group of 141 consecutive cases in which the intracameral illumination was used and on a standard cataract surgery group of 145 consecutive cases in which the intracameral illumination was not used. Main Outcome Measures. Intraoperative complications (posterior capsule rupture, radial tear of the anterior capsule, dropped nucleus, or sulcus-implanted/sclera-fixated IOL) and utilization of adjunctive devices (pupil expansion device or anterior capsule staining). Results. The frequency of use of the pupil expansion device was lower in the advanced cataract surgery group than that in the standard cataract surgery group (0.7% vs 6.9%; p=0.007). Furthermore, the rates of a posterior capsule rupture and at least one intraoperative complication were lower in the advanced cataract surgery group than those in the standard cataract surgery group (0.7% vs 4.8%; p=0.067) (0.7% vs 7.6%; p=0.004). Conclusions. In the current cohort of patients over 75 years, the rate of intraoperative complications was lower when using the intracameral illumination than that when using the conventional method. Cataract surgery using intracameral illumination would be good option for elderly people.


Eye ◽  
2009 ◽  
Vol 24 (2) ◽  
pp. 389-390 ◽  
Author(s):  
S Goverdhan ◽  
L Anderson ◽  
A Lockwood ◽  
J Kirwan

2003 ◽  
Vol 29 (3) ◽  
pp. 537-541 ◽  
Author(s):  
Fiona M. Chan ◽  
Ranjana Mathur ◽  
Jack J.K. Ku ◽  
Ching Chen ◽  
Siew-Pang Chan ◽  
...  

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Yawen Guo ◽  
Chengzhe Lu ◽  
Bin Wu ◽  
Jianmin Gao ◽  
Jun Li ◽  
...  

Purpose. To report the application of 25 MHz B-scan ultrasonography (MHzB) to determine the integrity of the posterior capsule (PC) in posterior polar cataract (PPC). Methods. Patients with whom PPC was clinically diagnosed using slit lamp microscopy who underwent 25 MHzB before phacoemulsification were retrospectively reviewed. The status of the PC was determined by 25 MHzB before phacoemulsification and confirmed during cataract surgery. Results. In total, 21 eyes in 14 clinically diagnosed PPC patients were enrolled in this study. Out of 25 MHzB images, 19 PCs were found to be intact, while 2 showed dehiscence before cataract surgery. During phacoemulsification, 17 PCs were observed to be intact, while 4 PCs showed posterior capsule rupture (PCR). These 4 PCR cases included the above 2 eyes, in which preexisting dehiscence was detected by 25 MHzB. The other 2 PCR cases showed high reflectivity between high echoes in posterior opacities and the PC, indicating synechia between the PPC and PC. Conclusion. This is the first report to show that 25 MHzB can be used to clearly visualize the status of the PC in PPC. These results, in turn, could be used to select the appropriate treatment and to thereby avoid further complications during PPC surgery.


2020 ◽  
pp. 112067212093766
Author(s):  
Pietro Maria Talli ◽  
Emilio Pedrotti ◽  
Riccardo Sacconi ◽  
Cristina Monterosso ◽  
Luigi Caretti

Purpose: To report a series of novel optical coherence tomography (SD-OCT) foveal abnormalities, that we called “T-sign,” that were noticed after a complicated cataract surgery with posterior capsule rupture and vitreous loss. Methods: Retrospective case series of persistent foveal changes that incurred after anteroposterior vitreo-foveal traction secondary to phacoemulsification in presence of posterior capsule rupture. Results: The study included three eyes of three patients that incurred in complicated cataract surgery and intraoperative vitreo-foveal traction. During 8-month follow-up period peculiar abnormalities in fundus examination and in OCT scans were reported in all cases. Conclusion: Phacoemulsification in presence of posterior capsule rupture could induce a vitreo-foveal strain that could be transmitted to the cone outer segment tips (COST line) and inner–outer segment (IS/OS) junction. This focal stress is liable for “T-sign,” a persistent SD-OCT abnormality that induce a visual impairment and a slight metamorphopsia in the fixation point. Summary statement All over the world, more than 9.5 million cataract surgeries are completed each year.1 During surgery, many intraoperative complications could occur, and capsule rupture with vitreous loss is a frequent event. Phacoemulsification in presence of a wide posterior capsule rupture and vitreo-macular adhesion could induce a typical modification of the foveal structure and a permanent visual impairment.


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