CATARACT AND LENS
Click on the “Clinical Education” or “Technical Education” bars to open the outline for that year and topic.
Year One
Clinical Education
- Cataract Surgery
- Indications for Cataract Surgery
- Management of Cataract – especially surgery
- Cataract Surgery Complications
- History and Ophthalmic Exam of Cataract Patient
- Differential Diagnosis of Abnormal Lens
- The Refraction of the Cataract Post-op Patient
- Clinical and Ethical Decision Making in Cataract Surgery
- Patient Communication in Cataract Surgery
- Instruction of junior trainees
- Cataract Surgery techniques
- Basic Steps of Cataract Surgery
- Anesthesia for Cataract surgery
- Sterile preparation of patient and instruments
- Instruments in cataract surgery
- Post-operative care of the routine cataract patient
- Knowledge of Lens Anatomy and Physiology
- Anatomy, embryology, and structure of the lens
- Physiology of the lens
- Epidemiology of cataract
- Most common types of cataract
- The etiology of the subluxated lens
- Optics in Cataract Evaluation
- IOL Calculation
- IOL types
- Instruments in the evaluation of the cataract patient
Technical Education
- Perform slit lamp exam
- Evaluate and classify lens opacities
- Perform subjective refraction in cataract patient
- Perform indirect and direct ophthalmoscopy as part of a pre- and post-op workup for cataract
- Sterile technique for the surgeon and operating room
- Perform patient preparation, sterile draping, and cataract anesthesia
- Perform the following steps of cataract surgery under direct supervision
- Wound construction
- Anterior capsulotomy/capsulorhexis
- Instill and remove viscoelastic
- Crystalline lens removal techniques
- Extracapsular
- Divide and conquer
- Phaco chop techniques
- Pre-chop techniques
- Miscellaneous techniques
- Perform irrigation/aspiration for cortical clean-up
- IOL implantation
- Sealing wounds
- Hydrodissection
Year Two
Clinical Education
- Advanced Cataract Surgery
- Technique for local injections in cataract surgery
- Basic preparation of the patient and operating theatre
- Use of the operating microscope
- Types and indications for different anesthesia in cataract surgery
- Pharmacology of the pupil in cataract surgery
- The steps of extracapsular surgery
- Viscoelastics in cataract surgery
- Irrigating solutions
- Detailed understanding of the instruments of cataract surgery
- Indications for complex techniques in cataract surgery
- History and techniques of IOL implantation
- Basic postoperative evaluation
- Common complications of cataract surgery II
- Paracentesis of the anterior chamber
- YAG laser capsulotomy
- Advanced Knowledge of Cataract and Lens
- Advanced causes and types of cataract
- Congenital and acquired lens anomalies
- Comorbidities in evaluating the cataract patient
- Glare testing and advanced testing of cataract patient
- Ultrasound in evaluation of the cataract patient
Technical Education
- Advanced techniques in cataract surgery
- Perform local injections
- Understand the operating microscope
- Perform the cataract surgery steps from year one with increased skill
- Paracentesis of the anterior chamber
- Advanced applications of viscoelastic in cataract surgery (iris prolapse, viscodissection, etc…)
- Perform the post-operative evaluation of a cataract patient
- Recognize and refer or treat common cataract surgery complications
Year Three
Clinical Education
- Complex indications for cataract surgery
- Phacoemulsification machine parameters and troubleshooting
- Complex cataracts and their appropriate surgical techniques
- Intraoperative complications and techniques to address them
- Intracapsular cataract surgery
- Indications for foldable or non-foldable lenses and implantation techniques
- Postoperative endophthalmitis and treatment
- IOL removal or exchange
- Government and hospital regulations regarding cataract surgery
Technical Education
- Understand and perform A-scan in IOL power measurements
- Perform phacoemulsification in the practice setting
- IOL repositioning and exchange
- Perform special IOL implantation techniques
- Management of intraoperative complications
- Vitreous loss
- Capsular rupture
- Anterior and posterior segment hemorrhage
- Positive posterior pressure
- Choroidal detachment
- Expulsive hemorrhage
- Loss of anesthesia
- Elevated IOP
- Small Pupil
- Management of post-operative complications
- Elevated IOP and glaucoma
- Astigmatism
- Post-operative refraction
- Corneal edema
- Wound dehiscence / wound leak
- Hyphema
- Residual cortex
- Dropped nucleus
- Uveitis
- CME
- Endophthalmitis (early and late)
- Posterior capsule opacification