key: cord-0871087-7l08gfs9
authors: Paul, Anujeet; Nagarajan, Swathi
title: Making the most of limited resources in wet-lab training during COVID-19
date: 2022-01-03
journal: Indian J Ophthalmol
DOI: 10.4103/ijo.ijo_1996_21
sha: 1394bed3d854cf5184ee26a364b8f59edf2dabc9
doc_id: 871087
cord_uid: 7l08gfs9

nan

The feel of an enucleated eye is different from live surgeries. An important cause for frustration when practicing in the enucleated eye is that the eye may move during surgery and frequently collapses during practice. The Spring-action Apparatus for Fixation of Eyeball (SAFE) helps in keeping the eye stable within the cylinder and also increasing the intraocular pressure so that the globe does not collapse. [4] This would be a worthwhile addition to the wet labs.

The practice of surgical steps need not be restricted to patients or wet lab. Ambidexterity can be encouraged by using a non-dominant hand in some everyday activities. Further, the commonly available household items can provide reasonably good simulation for certain surgical steps as demonstrated by Akkara et al. [5] In the wet lab, residents of different years can coordinate to practice steps most relevant to them, permitting the eye to be used by more than one resident. Though, not a replacement for hands-on surgical training on patients, this provides a reasonable means to practice skills when surgical opportunities are scarce during this pandemic.

Nil. 4 . Ramakrishnan S, Baskaran P, Fazal R, Sulaiman SM, Krishnan T, Unique experience from two-week Alcon phacoemulsification training program at a tertiary eye care centre Dear Editor, We read the very interesting and unique article by Farooqui et al. [1] on the multicentric Alcon phacoemulsification training program and we must congratulate the authors for bringing out this important analysis. The authors have broadly covered all the major and minor aspects of phacoemulsification training that are taught during this two-week program. However, we have few important points to add which we believe will be helpful to all the clinical ophthalmologists aspiring for this program in the future. 1. Before enrolling in this program, we believe that the surgeon should have mastered manual small incision cataract surgery (MSICS) [2] or must have performed at least 250 MSICS to be fluent in tissue handling. The same criteria were followed by our trainer during the program. 2. In the first week of training, the trainees must be allotted 1 case per day and 2 cases per day from the second week. This helps not only in building up the confidence and but also improves the OSCAR score of the candidate. The average OSCAR score, in the beginning, is 70, which improves to 85-90 at the end of the program. [3] 3. At tertiary eye care centers operating free patients under the National Program for Control of Blindness (NPCB) [4] scheme, the candidates can be initially trained on free patients through sclerocorneal phacoemulsification using PMMA IOL. 4. The last 2-3 cases should be clear corneal phacoemulsification as the candidate will be mostly performing clear corneal phacoemulsification in the future. [5] 5. This unique training program gives deeper insights into microscope settings, basics of instrument handling, core mechanisms of phacodynamics, and surgeon's hand position and posture while performing surgery, which a normal training program usually misses. The Alcon trainers are highly skilled candidates who take the responsibility of graduating you from a MSICS surgeon to a phacoemulsification surgery with a good follow-up. 6. Lastly, this program also provides you with a logbook where all the preoperative and postoperative details of the patients can be noted down. The logbook acts as evidence of your training program and the outcomes can be analyzed to achieve target refraction in future cases.

To conclude, we recommend that every ophthalmologist must undertake this unique phacoemulsification training program to understand the minute details of the technique and to become a better surgeon.

Nil. 

Wet-lab training during COVID-19 era; An ophthalmology resident's perspective

Impact of COVID-19 on ophthalmic specialist training in the United Kingdom -The trainees' perspective

Essentials of setting up a wet lab for ophthalmic surgical training in COVID-19 pandemic

Training Indian ophthalmologists in phacoemulsification surgery: Nine-year results of a unique two-week multicentric training program

Ophthalmic simulated surgical competency assessment rubric for manual small-incision cataract surgery

Evaluation of skills transfer in short-term phacoemulsification surgery training program by International Council of Ophthalmology -Ophthalmology Surgical Competency Assessment Rubrics (ICO-OSCAR) and assessment of efficacy of ICO-OSCAR for objective evaluation of skills transfer

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