Cataract surgery in special conditions

It is very important for a young cataract surgeon to know that not every patient with cataract is the same. Dermot McGrath reports

Dermot McGrath

Posted: Wednesday, February 10, 2021

Basak Bostanci Ceran

Strategies to deal with atypical and stressful scenarios that may occur during cataract surgery will be among the highlights of a special Young Ophthalmologists symposium at the 25th ESCRS Winter Meeting Virtual 2021, according to Basak Bostanci Ceran MD, Assistant Professor of Ophthalmology at Okan University School of Medicine, Istanbul, Turkey.
“As the most common surgical procedure in ophthalmology, cataract surgery usually presents the ophthalmologist with familiar sets of surgical routines. But sometimes we have special or atypical cases which should be addressed with several preventive measures,” said Dr Bostanci Ceran who will be chairing the symposium alongside Vincent Qin MD of Belgium.
The scope of the symposium will include presentations on a variety of such special circumstances, including systemic diseases, uncooperative patients, pre-existing retinal problems, glaucoma, ocular surface disease and phakic IOLs.
“Although the best source of knowledge is a surgeon’s own experience, sometimes we have to be prepared for rare complex cases by learning from others,” believes Dr Bostanci Ceran.
“Learning from others depends on a person’s ability to integrate his/her own experience with others. To do that successfully we have to abstract from single experiences and recognize the features that different situations have in common. This can be achieved by creating a network between surgeons, sharing knowledge and experiences as well as attending meetings like the ESCRS Winter Meeting and annual Congress where many interesting cases are shared,” she added.
With careful planning even the most difficult cases can have a successful outcome, points out Dr Bostanci Ceran.
“If the surgeon knows of preexisting challenges or notices risky eyes before the surgery, proper planning can alleviate surprises during the procedure. When the surgeon is unprepared, this challenge is intensified. The surgeon must know what to do if any complication occurs and prepare all the equipment to manage a possible complication, like pupil devices for small pupils, capsule tension rings (CTR) for weak zonules, sutures for scleral fixation or Cionni ring fixation and vitrectomy devices in the case of capsular rupture and vitreous loss,” she said.
Although there is no substitute for actual hands-on surgical experience, Dr Bostanci Ceran hopes that the online audience will take away some valuable lessons from the YO symposium.
“I believe it is very important for a young cataract surgeon to know that not every patient with cataract is the same and that this surgery is not always a standard procedure. Noticing special cases and getting prepared beforehand mentally and physically is the key to success. We aim to address some of those special conditions which we are likely to face in our practices and provide an algorithm on how to behave in such cases,” she said.
* Cataract surgery in special conditions, Sunday 21 February,9.30 a.m. – 11.30 a.m.

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