EyeWorld India December 2020 Issue

SECONDARY FEATURE 32 EWAP DECEMBER 2020 Recovering mentally from complications Uday Devgan, MD, Clinical Professor of Ophthalmology at UCLA, Los Angeles, California, shared a resident’s case video. To start, the resident surgeon was operating with an open posterior capsule and was, at times, losing pieces of the nucleus into the vitreous. The patient was going to need a pars plana vitrectomy and lensectomy. The first thing to do is “accept that you’ve had a complication and avoid denial. … Two, recover now and minimize the iatrogenic trauma.” Step three is to advocate for your patient. “There was a complication, whether it was an iatrogenic issue or the patient had bad tissue, and now you have to be your patient’s advocate to help them recover. You need to be able to ask for help. … There is no harm in asking for help, in fact, it is the right thing to do. Your patients will appreciate it.” Dr. Devgan said it’s important to take a breath, compose yourself, acknowledge the complication, decide how to best handle it, and be prepared to move on to the next case. “It’s important that you give 100% of your energy, your focus to the next patient. Most of us do many surgeries in a single day. If you have 10 surgeries lined up for the day and you have a complication on patient number three, understand that it’s going to take you longer to fix that complication, so now the rest of the patients are going to be delayed. That’s OK; give the time that the patient needs and for you to recover that complication. Also, you need to have your mind back in the game, your mind refocused so the patients in your surgical lineup are going to have your best efforts. You can’t dwell on what’s already happened.” Despite the extra surgeries that were needed in the case that Dr. Devgan used to highlight his point about mentally handling complications, he said the patient ended up doing great. Dr. Devgan’s steps for overcoming complications are: 1. Accept that there was a complication. Avoid denial. 2. Recover from the complication. Minimize iatrogenic trauma. 3. Be an advocate for your patient. Explain what happened postoperatively and ask for help when you need it. 4. Refocus, compartmentalize so you can give 100% of your effort to your next patient. Watch Dr. Devgan’s video at bit.ly/326asfw. Editors’ note: Dr. Devgan has interests with CataractCoach.com. along with iris hooks and pupil expanders. Exercise restraint when hydrodissecting and carefully adjust fluidics during the case, Dr. Mahendra said. EWAP Editors’ note: Dr. Mahendra is Director, Khairabad Eye Hospital and Mahendra Eye Institute, Kanpur, India. Dr. Oetting is Rodolfo N. Perez Jr., MD, and Margaret Perez Professor in Ophthalmology Education, University of Iowa, Iowa City, Iowa. Neither declared conflicting interests. True-K Formula ToricCalculator Universal II Formula RX Formula True-K Toric available at www.APACRS.org The latest update to the Barrett True K Formula, version 2.5, addresses yet another challenge to IOL power calculations—keratoconus. Selecting the option in the presence of keratoconus significantly improves the prediction of refractive outcomes and avoids unexpected hyperopia. Log on to www.apacrs.org and try it today! BARRETT IOL CALCULATOR NEWUPDATE!