Cataract surgery Fundamentals and check list

Mastering Surgical Ergonomics and Psychomotor Skills

To become a great surgeon—both in simulation and the operating room—you must start with fundamentals. One of the most critical aspects is ergonomics, followed by mastering hand biomechanics for precise control.

Step 1: Perfecting Your Ergonomics

  • Chair Positioning: Sit back in the chair with shoulders relaxed and maintain a 90° angle at your knees and elbows.
  • Foot Pedals: Both feet must be firmly placed on the pedals.
  • Back Position: Hyperextend slightly for a power position that prevents strain.
  • Simulator Adjustments: Ensure correct height, angle, and interpolar distance before starting.

Step 2: Hand Biomechanics – “Macro Control, Micro Precision”

To navigate the anterior chamber with accuracy, adopt the right hand positioning:

  • Fixation Point: Fingernails touch the patient’s forehead while maintaining a vertical wrist.
  • Instrument Grip: Hold the second instrument (chopper, forceps, etc.) at 180° with third phalanx contact for control.
  • Pivoting Technique: Float through the incision while ensuring centered eye stability.

Step 3: Adjusting for Handpiece Movements

When handling the phaco handpiece, the biomechanics shift:

  • Heavier Instrument Considerations: More flexibility in hand positioning.
  • Rotational Movements: You can rotate, verticalize, and navigate differently from second instruments.
  • 3D Spiral Navigation: Adjusting movements for optimal intraocular precision.

Final Takeaway: Perfecting ergonomics and hand biomechanics takes time, but once mastered, they will significantly enhance your surgical skills. Stay patient, stay focused, and keep refining your technique.

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