Hammaad Khalid
Ophthalmology represents a unique blend of medicine and meticulous surgery. The slightest movements are significant. For medical students and doctors considering a career in ophthalmology, it is important to have exposure to the field and an insight into microsurgery. The introduction to microsurgery skills course organised by The Royal College of Ophthalmologists (RCOphth) in London provides that essential exposure with an emphasis on setting strong foundations under consultant supervision.
The day commenced with an introduction to microsurgical principles and an understanding of ophthalmic instruments. Attendees were given the opportunity to familiarise themselves with the instruments and to learn the most efficient ways to handle them. Emphasising the importance of good foundations and effective surgical practice. Using the microscope efficiently was another important aspect, with teaching focused on effective positioning, posture, and ergonomics. Discussion on this, highlighted the importance of good positioning not just on efficiency of surgery but also career longevity.
A crucial aspect that the course introduced was suturing. Participants initially started learning without the microscope and then built up to suturing under magnification. Initial practice was focused on learning and practicing the different knots and controlled hand movements. Then transitioned into working under the microscope with increasing complexity of the required tasks. This facilitated building coordination and getting the brain familiarised with the depth perception necessary for microsurgery. This delivered in a step-by-step way helps with skill acquisition and tackling the steep learning curve.
Over the course of the day the complexity of the tasks increased. Starting with different suturing techniques and wounds, squint surgery simulation and eye lid laceration repair. Each task was first demonstrated by faculty followed by practice which was closely supervised with direct one-to-one feedback. This increase in difficulty in a staged progression helped to navigate the complexity of surgical procedures. Additionally, attendees were introduced to the fundamentals of cataract surgery and the three-step corneal incision. Being able to practice learned skills on models and animal tissue, in a controlled environment provided a realistic setting to consolidate the learning.
Candidates had the opportunity to use The EyeSi surgical simulator. This virtual environment offers an opportunity to learn, practice and develop microsurgical skills, vital for ophthalmic training.
Despite the course being an introduction to microsurgery, it was able to provide a great insight into the demands and skills needed to become an ophthalmic surgeon. The skills that were introduced are the foundations and therefore would need refining and consolidating in a clinical setting. The course makes for a unique opportunity for early hands-on experience with close expert supervision and feedback and helps to confirm ophthalmology as a future career choice.
Overall, the microsurgical skills course provided an essential introduction to ophthalmic surgery. Through its structured teaching, simulations, and supervision, it offered a unique insight into the precision and technical skills needed for ophthalmic surgery. This course is an essential training exercise for anyone with an interest in ophthalmology and I would definitely recommend it!