EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/78716
March 2012 EW RESIDENTS 115 form surgery at the level of experi- enced surgeons and providing pa- tients optimal outcomes. Intraoperative maneuvers to address tremors include better stabilization of fingers and instruments. For most novice surgeons, using both hands to stabilize instruments in the eye, a superior approach with hand sup- port on the forehead or using a wrist rest can be beneficial. Adjusting the microscope, chair, and foot pedals to improve comfort also help reduce anxiety and tremors. Tremors not improved with practice may benefit from use of 10- 40 mg propranolol hydrochloride 1 hour prior to surgery.1,2 In addition, developing a pre-op routine with appropriate amount of sleep and avoiding caffeine can help as well.2 Counseling should also be consid- ered for trainees having a difficult time coping with the stress associ- ated with residency. The vast majority of residents complete training with excellent sur- gical skills and can eliminate or compensate for tremors during sur- gery with practice in the wet lab and virtual simulators, anti-anxiety remedies that may include pharma- cotherapy, and attention to lifestyle choices prior to surgery. Eydie G. Miller, M.D. Professor of clinical ophthalmology Director, Glaucoma Service Scheie Eye Institute University of Pennsylvania Health System Philadelphia A hand tremor can be a problem when performing delicate intraocu- lar surgery. Performance anxiety is more common in a fledgling sur- geon. Both the excitement of doing a case and the fear of making a mis- take can cause an adrenaline surge that results in a hand tremor and tachycardia. That might not be problematic if you're amputating a limb, but it is with microsurgery. However, adrenaline is part of the body's normal response to dealing with an important or stressful situa- tion. It focuses the mind and im- proves our attention to detail. Attention to the following pre-op and intraoperative factors can help prevent or lessen a hand tremor. Pre-op: 1) Be prepared. Use sur- gical videos to review the steps of the operation, then practice them in REGISTER NOW: IF YOU ARE A DRIVER OR AN EARLY ADOPTER OF NEW OPHTHALMIC SURGICAL TECHNOLOGIES/TREATMENTS. APRIL 19, 2012 t THE RITZ-CARLTON, CHICAGO, IL THE DON'T MISS OPHTHALMOLOGY INNOVATION SUMMIT ΈK/^Ή Ν ^ Z^ Will unite thought leaders in anterior ƐĞŐŵĞŶƚ ǁŝƚŚ Ă ĨŽĐƵƐ ŽŶ ĨĂĐŝůŝƚĂƟŶŐ ŽƉŚƚŚĂůŵŝĐ ƐƵƌŐŝĐĂů ŝŶŶŽǀĂƟŽŶ PROGRAM AGENDA: 11:30-1:00 Registration and Buffet Lunch 1:00-1:05 Welcome- Emmett Cunningham, MD 1:05-1:20 The Innovation Cycle in Surgical Ophthalmology- William Link, PhD Micro Invasive Glaucoma Surgery (MIGS) 1:20-1:40 The Current State, Unmet Need and Size of the Opportunity 1:40-2:25 Company Presentations-Moderator Gil Kliman, MD 2:25-3:00 Panel: MIGS in Perspective-Moderator Dick Lindstrom, MD 3:00-3:30 Break Enhancing Refractive Outcomes in Cataract Surgery 3:30-3:15 The Current State, Unmet Need and Size of the Opportunity 3:15-3:45 Panel: Femtosecond Lasers- Current State and Future Impact 3:45-4:15 Panel: Premium IOLs: Current State and Future Impact 4:15-4:45 Panel: Intraoperative Aberrometry: The Current State and Future Impact- Innovations in Surgical Ophthalmology: Summary and Observations 4:45-5:00 A Clinician's Perspective- Dick Lindstrom, MD 5:00-5:25 Perspective of the Medical Device Industry- (Lessons Learned as President of ADVAMED)- Jim Mazzo 5:25-5:30 Wrap-up Bill Link 5:30-6:30 Reception MISS : Ophthalmic Surgical Innovation Progress THE YEAR IN REVIEW: thalmic Sur THE OPHTHALMOLALMOLOGY INNOV ATION SHOWCNNOVVATION N SHOWCASE: ompan CASE STUDIES ON SUC s the surgery lab. The more accus- tomed you are to working under a microscope, handling the instru- ments, and suturing, the less anx- ious you will be during the case. 2) Avoid caffeine the morning of sur- gery. 3) Avoid strenuous exercise such as weight lifting on the day of surgery, which can stress the hands and cause an exercise-induced tremor. 4) Get a good night's sleep. 5) If all else fails, consider a beta continued on page 117 Private Compa any Technology Presentatioons ES ON SUCCESS STORIES AND LESSONS LEARNED: Bringing new t technolog ies in Minimally Invasive Glauccoma Surgery to Market D LESSONS LEARNED: THE AUDIENCE NCLUDESS : INCL Innovators/Enntrepreneurs, Surgeons, Aca Ve ublic Companies. ublic C FOR MORE INFORMAFORMATTION CONTACT: INF Craig Simaki Si k International Business Forumusiness Forum, I, Inc . 516) 307-0743 or cr3 or craig@ibffc (516) 307-0743 or cr WWW.O P H T H A LMOLO G Y SUMMIT . COM Presented by conffe erences.com m cademia, ademia, Venture Capitalists and Indualists and Industrstry Leaders fr fr om Private and Pu IENCE tions