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Basic Principles of Ophthalmic Surgery, Fourth Edition



Basic Principles of Ophthalmic Surgery, Fourth Edition PDF

Author: Ayman Naseri MD

Publisher: American Academy of Ophthalmology

Genres:

Publish Date: June 1, 2019

ISBN-10: 1681042207

Pages: 290

File Type: PDF

Language: English

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Book Preface

Many years ago when the American Acad emy of Ophthalmology began development of Basic Princi ples of Ophthalmic Surgery, respected educators immediately recognized the need for a comprehensive resource to aid in navigating the surgical learning curve ex-perienced by all ophthalmology residents. Led by Dr. Anthony Arnold in its inaugural edition and by Dr. Thomas Oetting in the second edition, this book shares the collective knowledge and experience of passionate surgical educators accumulated over thousands of hours of professional dedication. The hope is that residents and educators from around the corner and around the world can benefit from this text in traversing among the most challenging aspects of residency training: the interface between the patient and the novice surgeon.

This edition is divided into 4 major sections: Evaluation and Preparation, Surgical Logistics, Intraoperative Considerations, and Postoperative Considerations. All chapters have been updated where appropriate, with par tic u lar revisions made to the chapters on ergonomics, intraocular fluids, patient safety issues, and postoperative management.
To all of the authors of this book, we are grateful for your generous contributions of time, effort, and expertise, and offer thanks on behalf of many future generations of oph-thalmologists. I am also personally grateful for the support of Susan Malloy and Amanda Fernandez for their patience and guidance in creating this edition.

Ayman Naseri, MD
Ophthalmology Residency Program Director, University of California
Chief of Ophthalmology at the San Francisco Veterans Affairs Medical Center San Francisco, California

Acknowledgments

The Acad emy wishes to acknowledge the following people who reviewed the third edition and suggested changes for the fourth edition. For the Committee on Resident Education: Eric Brown, MD; Laura Green, MD; Andrew Hendershot, MD; Thomas Hwang, MD; Carolyn Kloeck, MD; Shannon McCole, MD; Lois McNally, MD; Andrew Melson, MD; Jeff Pettey, MD; Donovan Reed, MD; Adam Rothman, MD; R. Michael Siatkowski, MD; Meryl Sundy, MD. For the Basic and Clinical Science Course: Mary K. Daly, MD; Robert S. Feder, MD; Stephen J. Kim, MD; Bobby S. Korn, MD, PhD; Robert W. Hered, MD; Stephen E. Orlin, MD; Angelo P. Tanna, MD; Linda M. Tsai, MD; David D. Verdier, MD; George O. Waring IV, MD.
A special thanks to Richard Caesar, MBBS, FRCOphth, and Bryn  M.  Burkholder, MD, for providing videos.

The Acad emy thanks the following for supplying photo graphs for the instruments chapter, including Anthony Kroboth, Ambler Surgical; Anne Bohsack, FCI Ophthalmics; Gordon Dahl, Katena Products; Larry Laks, MicroSurgical Technology; Scott Heck, Wil-son Ophthalmic; and Amy Wang, ASICO, LLC. Photo credits: figures for this chapter are courtesy of Ambler Surgical unless other wise noted. Figures 8-18, 8-19, 8-40, 8-44, and 8-47 are courtesy of FCI Ophthalmics; Figures 8-38, 8-39, 8-54, 8-67, 8-68, 8-74, 8-75, and 8-85 are courtesy of Katena Products; Figures 8-41, 8-42, 8-46, and 8-69 are courtesy of MicroSurgical Technology; Figure 8-70 is courtesy of ASICO, LLC; Figures 8-73 and 8-90 are courtesy of Wilson Ophthalmic, and Figure 8-72 is courtesy of Surgilūm.

Foreword

How do you teach surgery? How do you learn surgery? We surgeons have vivid memories of events in our surgical learning path— the first time we scrubbed in as medical students, the first time we sutured a laceration, or the first time we touched a beating heart— and many, many more.

As ophthalmologists, we remember the first successful cataract surgery and the pa-tient’s vision the next day— and we remember our first serious intraoperative complica-tion and the steps we took to manage it. We likely all shared a similar surgical learning pro cess in residency training as we built on our general medical and surgical experience, sequentially adding knowledge, specific manual maneuvers, and procedural components through a combination of didactics, surgical “wet laboratories,” observation, and super-vised patient experience. Then, under supervision, we assembled it all into the complete package as primary surgeons.

Is that the best way to learn surgery? Ultimately, no. In an ideal system, ophthalmic surgical simulation technology will soon allow us to gain not only technical proficiency but also experience in intraoperative decision making and complication management. When surgeons in training then perform their “first cases” as primary surgeons, they will do so having had impor tant near- real- life experience. The pro cess will benefit surgeons in training and patients alike.
But surgery is much, much more than the technical per for mance of a set of skill com-ponents. A well- constructed set of surgical learning objectives must involve many subjects, including the biomechanics of wound construction and healing, instrument design, surgical materials (such as sutures and irrigation fluids), and sterility and infection control. It should include patient se lection, the informed consent pro cesses, medical ethics, postoperative management, and complication avoidance and management, among other topics.

For ophthalmology, surgery is a core and a complex competency, and education in this complex subject remains a pro cess equally daunting for teacher and student alike. Any-thing that can facilitate the pro cess benefits future patients. Basic Princi ples of Ophthalmic Surgery, together with the Acad emy’s companion volume, Basic Techniques of Ophthalmic Surgery, packages many of the key ele ments of the surgical pro cess and environment into an invaluable adjunct to the learning program for residents.

Simulators, texts, and videos are only imperfect tools in this educational pro cess. But they can better prepare us to meet its challenges. There is one other critical component to surgical education— the experienced operative teacher and mentor who sits (or stands) at our sides and guides us through the exciting, exacting, and at times stressful pro cess of altering living human tissue. This volume, with both text and video, reflects the commit-ment and talents of some of those incredible ophthalmic educators who have shepherded the earlier editions.

As surgeons we have a profound obligation to our patients. They honor us by trusting to us their sight and sometimes their lives. This text acknowledges the scope and complex-ity of that obligation.

David W. Parke II, MD
Chief Executive Officer
American Acad emy of Ophthalmology


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