By DR. MARK SIEGEL
When we watch videos of cataract surgery, it seems like a solo act by the surgeon. While the surgeon is the most crucial member of the team, always remember that cataract surgery is teamwork.
The team members in the United States often include:
– the surgeon (the ophthalmologist)
– the scrub tech (surgeon’s primary assistant)
– the anesthesiologist or anesthetist
– the circulating nurse
– the ophthalmic tech in the clinic
– the pre-operative nurse
– the post-operative nurse
– the surgical coordinator/scheduler
– the rest of the team
Remember that a great surgery requires that the entire team is functioning and working together.
Recently I was working with a new scrub tech and new nurse for the first time. The nurse had difficulty with prepping the eye. This resulted in a central corneal abrasion which impaired the view during the entire surgery.
In cataract surgery there are many steps which I rely on the team for optimal results:
– avoidance of a central corneal abrasion from the prepping
– better draping of the patient to provide an optimal operative field
– accurate head positioning to place the iris parallel to the floor
– not allowing saline to touch the microscope lens in the middle of a case
– handing the correct instruments in proper order
These are, admittedly, minor issues and the patient still ended up achieving a beautiful result and 20/20 vision. Also, the surgery was completed in 10 minutes without complications or issues.
But still, the critic in me says that it could have been just a bit better. And that’s what cataract surgery is about: getting incrementally better every case.
When my scrub tech, who has helped me with thousands of cases, makes a suggestion during surgery, I always heed her advice. Her opinion is valuable and she has insight that is not tainted by the hint of denial that we surgeons sometimes have.
The anesthesiologist understands the patient’s systemic health far better than any ophthalmologist and I always trust his/her judgment. When my anesthesiologist tells me that it’s better to postpone surgery for a particular patient for medical reasons, I trust their judgment and do exactly that.
Cataract surgery is elective, and there is no sense in taking unnecessary risks to do a surgery today if it can be done in a safer manner in a few weeks.
Every time I operate, at the end of the surgical day, I take time to thank each and every member of my surgical team. I have done this for 15 years in private practice – 20 years when residency and fellowship is included.
Dr. Mark Siegel is the medical director at Sea Island Ophthalmology at 111 High Tide Drive (off Midtown Drive near Low Country Medical Group). Visit www.seaislandophthalmology.com.
