- 19 Sep, 2024
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Phacoemulsification Course 2025
Phacoemulsification Course
Phacoemulsification is the process of removing a cataract from the inner eye.
It is very difficult to simulate a real-life cataract removal but the use of a phacoemulsification
machine and an artificial cataract within an animal or human eye is the best way to do so.
This, however, can be a double-edged sword.
Phacoemulsification of a cataract requires a great deal of skill and precision.
Without proper training and experience, there is the potential to cause damage
to the posterior chamber of the eye as well as the cornea.
This may not be detrimental in a simulated environment but if a novice surgeon
were to cause such adverse events on a real cataract patient, it could potentially be career-ending for that individual.
A phacoemulsification course for surgeons typically covers the principles, techniques,
and practical aspects of performing cataract surgery using phacoemulsification.
Here’s an outline of what such a course might entail:
1- Introduction to Cataract Surgery:
Phacoemulsification is a modern cataract surgery in which the eye’s internal lens is emulsified
with an ultrasonic handpiece and aspirated from the eye.
It is a vital procedure in the field of medicine as cataracts are the leading cause of impaired
vision and blindness among the elderly throughout the world.
Left untreated, cataracts will eventually cause blindness in most individuals.
There are an estimated 16 million individuals in the United States over the age of 40 with cataracts.
Today, patients are deciding to have cataract surgery when the cataracts
are still in the early stage of development.
As a result, ophthalmologists need to become trained in cataract surgery and more specifically,
phacoemulsification techniques.
2- Principles of Phacoemulsification:
Learning about the principles of phacoemulsification,
including ultrasound energy, fluid dynamics, and machine settings.
The course will cover all fundamental aspects of cataract surgery in a logical step-wise fashion.
Lectures will cover topics to provide a successful framework to understand and learn the technique.
Step-by-step instructions will be provided on the key concepts of cataract surgery.
Safe techniques will be emphasized throughout the course with special attention
directed to wound construction and phacoemulsification parameters.
After the course, attendees will have gained significant hands-on experience through model
eyes and should have the confidence to incorporate the learned techniques into actual surgery.
The primary goal of the Phacoemulsification Training Course is to assist beginning phacoemulsification
surgeons in learning the basic techniques required to perform cataract surgery.
Instruction will emphasize the development of sound surgical techniques and avoidance of complications.
A secondary goal is to provide practicing surgeons with minimal experience in phacoemulsification
an opportunity to learn the technique and thereby improve the quality of cataract surgery in the community.
3- Preoperative Assessment and Patient Selection:
Evaluating patients for cataract surgery, including assessing visual acuity, and ocular health,
and determining candidacy for phacoemulsification.
4- Surgical Techniques:
The phacoemulsification course focuses on teaching surgical techniques and Hands-on
training in various surgical techniques involved in phacoemulsification, including:
– Corneal incisions
– Capsulorhexis (creating a circular opening in the lens capsule)
– Phacoemulsification of the cataractous lens
– Irrigation and aspiration of lens material
– Intraocular lens (IOL) insertion
The phacoemulsification course will present each step of cataract surgery,
with particular emphasis on those steps unique to phacoemulsification.
The removal of a cataract with the “divide and conquer” (groove and trench) techniques
or by chopping is inherently ICCE with the removal of the lens material in toto,
hence the conversion to phacoemulsification requires a change in technique,
in particular the ability to recognize and divide the nucleus into smaller fragments which are then emulsified and aspirated.
This learning process is best done in a planned manner by initially converting the divide
and conquer technique to a form of phaco in which the first fragmenting and removal
step is done with minimal damage to the surrounding capsular bag (stop and chop technique).
This can be in turn preceded by a practical step in which one learns to sculpt the nucleus,
this being the most conservative way of removing cataracts by phacoemulsification.
The evolution of phacoemulsification in the long term to a cortical sparing procedure
is best left until competency in nucleus management has been achieved.
5- Step-by-Step Procedure
The phacoemulsification course includes all the steps of surgery, which are:
Anesthetic and Incision Anesthetic drops are instilled, and an anesthetic gel is used to numb the eye.
A small incision is made at the junction of the cornea and sclera with a blade.
With the use of a high-magnification microscope, the surgeon can see the cataract clearly,
even while working inside the eye.
This is very important in ensuring safety and success in the removal of the cataract.
Phacoemulsification is performed with the patient lying on their back in a special operating chair.
The patient’s eye is numbed using anesthetic drops, and an eyelid holder
is used to hold the eye open during the procedure.
Using a fine ultrasonic probe that is inserted through a very small incision in the cornea,
the surgeon will be able to remove the cataract
6- Complication Management:
Recognizing and managing intraoperative and postoperative complications such as posterior capsule rupture,
corneal edema, and IOL dislocation.
Recognizing and preventing complications is the most effective method of minimizing their impact on the patient.
Good surgical technique helps prevent complications in the first place.
If a complication does occur, an effective management strategy will limit the impact of the complication.
7- Postoperative Care and Follow-up:
Understanding postoperative care protocols, managing common postoperative complications,
and scheduling follow-up visits.
The phacoemulsification course finally will be discussed because the final step in mastering
phacoemulsification is providing appropriate postoperative care for the patient.
While cataract surgery is successful more than 98% of the time,
certain steps should be taken to ensure optimal results.