Eyeworld

N AUGUST 2020 | EYEWORLD | 29 "I have no doubt it will keep getting better, and I would not be shocked if within a de- cade most ophthalmic surgery is 'virtual,' with surgeons relying on external displays or aug- mented reality rather than traditional operating microscopes. … The further we get away from microscopes, the more natural it will be to have training virtually," Dr. Goshe said. Overall, Dr. Goshe said the pandemic has shown that residents were able to handle the situation better than he thought. "We haven't seen the full effect—there is still a full class of residents and fellows who are likely to be more impacted by this—but I think that with using these platforms (surgical simula- tion and wet laboratories) as a way to maintain skills, early experience has been that residents have adapted well, and I think time will bear that out. From what I've seen, they've handled it beautifully." anterior chamber and giving immediate feed- back about whether you're going too high or too low, training that depth perception. It also gives an objective assessment of quantitative variables such as capsulorhexis uniformity and surgical efficiency." What virtual simulation doesn't do is totally recreate the tactile, hands-on feeling of working in an eye with fluidics. "It's a different experience when you have an actual human or animal eye," Dr. Goshe said. Virtual simulation also doesn't address the nuances of different surgical equipment made by different companies, such as the different phacoemulsification platforms, he said. There have been improvements in surgi- cal simulation in the last decade, Dr. Goshe continued. But to get to something that would replace non-virtual, all-hands-on equipment, actual ophthalmic surgery itself would have to become more automated or virtual. Dr. Goshe mentioned doing surgery off of a 3-D display vs. looking through microscope oculars as an example. Relevant disclosures Goshe: Dompe M anjool Shah, MD, assistant professor, Kellogg Eye Center, University of Mich- igan, Ann Arbor, Michigan, during the YES symposium at the 2020 ASCRS Virtual Annual Meeting, presented on how to keep surgical skills sharp, a topic that's still relevant as volume might be below normal. He explained that surgical skills first start in your head, not your hands, so Dr. Shah recommend- ed watching video of your routine cataract cases, taking notes, drawing diagrams, and imagining where you would make the incisions. While watching, consider the "why" behind everything you did and didn't do. In watching complicated case videos, Dr. Shah said it's important to go back and see why the complication hap- pened in the first place. Dr. Shah also mentioned devices and implants that can be used for training at home, such as the model eye SimulEYE (InsEYEt). With these and other pearls, Dr. Shah ended his presentation by saying that they apply whether in a pandemic or not. Keeping up surgical skills "[W]e can use this opportunity to develop ourselves and be that much better when this crisis is over," he said. Attendees of the 2020 ASCRS Virtual Annual Meeting can watch this and other presentations on demand at ascrsvirtualmeeting.ascrs.org. Relevant disclosures Shah: Allergan, Glaukos, Katena Contact Shah: manjool@med.umich.edu

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