Phaco training can be adapted for left-handed trainees

By compartmentalizing the steps involved in phacoemulsification surgery, left-handed ophthalmic trainees can have a smoother learning curve without jeopardizing patient outcomes, according to a group of British surgeons.

M.J. Freeman and colleagues described how they adapted a training program used by the Worcester Eye Department for phaco training to accommodate a left-handed trainee.

For modular training, the phaco procedure is divided into steps, each requiring more technical expertise than the previous step, the authors said. With a right-handed surgeon teaching a left-handed trainee, potential concerns include the inability of the trainer to hand over surgery at a 12-o’clock position without the trainee adopting a right-handed approach.

“To accommodate the left-handed trainee, left-eye cataracts were approached through a clear corneal temporal incision at 45·, allowing the trainee to sit above the patient to perform their step. Right-eye cataracts were approached through a clear corneal superior incision at 135·, with the trainee operating from the temporal side,” the authors said in the January issue of Eye.

In 161 cases using this modified approach, there was one case of vitreous loss and one posterior capsular tear with no vitreous loss, the authors reported. One case was converted to an extracapsular technique. Two cases developed stable anterior capsular tears and two cases required a single suture to ensure wound stability.