- 17 Sep, 2024
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Phaco Training Course from MoAcademy
Phaco Training Course
With the increasing trend towards phacoemulsification,
A Phaco training course is necessary for the surgeon.
The increase in complications observed during the learning curve creates a dilemma
as to the optimal point at which a trainee surgeon can safely learn the technique.
The popularity of small-incision cataract surgery has increased over laser procedures.
Phacoemulsification was chosen by 52% in a survey by the American Refractive Surgery Society,
as opposed to extracapsular cataract surgery.
The UK practice is also changing rapidly towards phacoemulsification.
Phacoemulsification is based on a different principle and involves different techniques
than sular cataract surgery,
so the surgeon must acquire new surgical skills to perform phacoemulsification.
Learning phacoemulsification is an essential skill to acquire, and it is considered
a vital aspect of ophthalmic education.
Even with the development of different guidelines and syllabi,
residents’ real-world educational experiences are not the same,
and many factors affect how they learn.
Phaco training course outside the operating theatre
Laboratory practice provides surgeons with the opportunity to gain skills in a controlled
environment without the pressure of operating on real patients
The steps of cataract extraction are practiced in wet laboratories with either cadaveric
human or animal models or synthetic eyes designed specifically for phacoemulsification.
Phaco training course program
During the Phaco training course, the surgeon needs to gradually practice the steps, including:
First step : intraocular lens (IOL) implantation
Second step: incision construction
Third step: cortex removal
Forth step: continuous curvilinear capsulorhexis.
Fifth step: nucleus fragment emulsification.
What are the steps you need to know during the phaco course?
Step 1: Study the Fundamentals
The first step is to learn the basics of phacoemulsification.
Focusing on the basic concepts at this point is advisable instead of studying the nuances,
like: the fundamentals of different phaco machines, the utilization of necessary materials
and instruments, the anesthesia settings, and the procedures involved in phaco
surgery and their significance.
Step 2: Build Manual Dexterity
To be successful in training as a surgeon, it’s important to practice bimanual coordination,
minimize tremors, and develop spatial awareness of their hands.
Before commencing work under a microscope, these goals can be achieved to a certain extent.
Practicing suturing in a wet lab and placing sutures for trauma patients in an emergency
department can help improve manual dexterity.
Step 3: Basic Phaco Steps
The phaco procedure is typically divided into stages, with the first step being draping
and speculum insertion and then finishing with phacoemulsification itself.
The most difficult phaco steps to perform are creating and dividing the nucleus,
as many ophthalmologists agree.
The doctor must know what complications may occur during this stage,
the most important complications to recognize include radial tears in the capsulorhexis margin,
posterior capsular rupture, and a run-out capsulorhexis
Some signs of posterior capsular rupture include an iris snip, vitreous prolapse,
and shallowing of the anterior chamber
Recognizing such signs as early as possible will enable better handling of complications.
At the same time, new phaco surgeons need to practice skills under the microscope
in a wet lab or OR in surgery when possible.
This can help to build their confidence in handling a microscope, including how to gain optimal focus,
control pedals with different functions, and become familiar with the surgical view.
After completing these tasks, the surgeon can begin performing simple extraocular surgeries,
such as removing benign masses in the adnexal region,
removing suture threads from the cornea, and removing pterygiums under a microscope.
By practicing these operations, the trainee’s fear of intraocular surgery can be reduced.
The use of surgical videos can assist in the study and improvement of manual dexterity
Step 4: Perform a Full Phaco Procedure
Before performing a full phaco surgery, it is essential to master the handling of intraocular
instruments and be aware of common complications and strategies for their management.
Step 5: Use your mentors
Make it a point to have regular discussions and exposure to the operating room with faculty.
By doing this, you can establish a meaningful mentorship and gain the most valuable
knowledge from more experienced surgeons.
Step 6: Watch surgical videos
Video presentations are also a great way to become acquainted with surgical cases
Details of Phaco training course at MoAcademy
1- Introduction of Phaco Course
During the first phase, trainees will take an introductory course to help them grasp the process better.
During the introduction phase, the trainees will learn theoretical information regarding
fluid dynamics and Phaco Dynamics.
Under the supervision of a senior specialist, the trainee receives daily training
in both preoperative patient assessment and postoperative management of the patients,
in case of a complication to observe how post-operative care is being handled.
Explaining the tools used in surgery, In particular, the phaco machine,
which consists of a handpiece, foot pedal, and irrigation and aspiration system.
Therefore, it is essential to use phaco energy carefully and safely.
2- Wet-Lab Training:
Wet labs provide a safe and standardized training method without the risks associated
with actual eye surgery.
Therefore, trainees are better equipped when operating on real eyes.
Additionally, this allows trainees to perform the same surgical procedure
multiple times without complications or failures.
This will give confidence to aspiring surgeons.
This also helps improve psychomotor skills, hand-eye coordination,
and ambidexterity, which are very important in ophthalmology.
Trainees can also ask questions they were previously too scared to ask,
or “what if” questions that would embarrass them in front of patients or colleagues.
This creates a less stressful environment for trainees.
This allows them to quickly learn from their mistakes.
In short, this not only prepares trainees but also provides a safe working environment
in which they can practice without the threat of catastrophic complications.
Because of the anatomical differences between animal and human eyes,
cataract surgery in animals may require a distinct technique,
but it is a good way to practice in the laboratory and train hand skills
This will enable the trainees to successfully adjust the limbs of the phacoemulsification
device and also provide a deeper understanding of human/artificial cell nucleus chopping techniques.
2- Surgery in Steps:
- Clear Corneal Incision
- Anterior Capsulorhexis
- Phaco Trenching
- Phaco Chopping
- Irrigation and Aspiration
- Foldable IOL Implantation
- Stromal Hydration and Intracameral Injection of Antibiotics
The irrigation and aspiration systems are essential to the basic operation of phacoemulsification.
- Irrigation
To maintain steady fluid dynamics inside the chamber, continuous irrigation—which involves
passing fluid through the phaco tip’s sleeve with little passage through the primary
incision—is a crucial step in the phacoemulsification process.
Coaxial irrigation reduces heat generation, helps cool the ultrasonic tip,
and guards against tissue injury.
Maintaining a steady anterior chamber is another benefit of irrigation.
- Aspiration
A thorough understanding of the phacoemulsification aspiration system plays an
important role in improving a surgeon’s phacoemulsification performance without
damaging adjacent tissues such as the iris and capsule.
The phaco training course teaches cataract surgery using ultrasound phacoemulsification.
This practical training program is specifically aimed at ophthalmologists who are familiar
with SICS and wish to improve their skills as a phaco surgeon.
MoAcademy Phaco training course
MoAcademy designs a proficiency-based training methodology that would increase trainees’ confidence,
reduce training costs, and improve patient safety.
The program offers both theoretical and hands-on skills training and takes place in an actual
operating room with actual surgical tools and utilizing a plastic model eye to build up trainees’ surgical skills.
The skill training focuses on imitating the instrument maneuvering inside the plastic eye.
Before performing operations on patients, trainees must master the knowledge
and skills required in all steps of this training program.
Once each step is understood, the trainees will rehearse the entire procedure repeatedly
until they have a thorough understanding of the procedure.
By the end of the training program, trainees will have a complete comprehension
of the procedure and good eye-hand coordination.
Since nothing was unfamiliar except for handling biological tissues,
they would feel more confident when it came to their initial case.
We offer the best Phaco Training course.
The phaco course is customized to meet the needs of each physician.
This step-by-step course will give the surgeons confidence to perform
independently after the completion of the course.
Advanced instrumentation and Experienced Faculty are available.
By the end of the course, trainees will be confident enough to handle their own Phaco procedures.
Certification of Phaco training course
All the trainees receive a signed Certificate at the end of the phaco course done at our center.