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Up Front | Aug 2009


The following letters refer to the article titled, "Reducing Complication Rates: Strategies for Beginning Cataract Surgeons," by Laurence Sperber, MD; Richard E. Braunstein, MD; and Uday Devgan, MD. The piece appeared in our June 2009 issue.

I want to thank Dr. Devgan for his comprehensive list of questions posed to his residents as they train to do cataract surgery. I have been performing surgery for 20 years, and I continually try to improve my techniques. His questions should encourage all surgeons to re-evaluate how and why we proceed with each step of the operation. We must strive to know and understand improvements in technology and utilize them for the benefit of our patients. I appreciate Dr. Devgan's questions for beginners. We would all benefit by knowing the answers.

Stephen T. Kondash, MD

I read this article with great interest. I think it is an important piece, as it highlights an approach, which if adopted, might carry great benefits to the training of the residents, as well as patient welfare. Sometimes, there is an incomplete or unclear understanding of one or more basic ocular surgery principles when residents start building their surgical skills. This can lead to trial learning, overwhelming the resident, and giving rise to mistakes that could be easily avoided with a deeper understanding of ocular surgical management.

The questions that Dr. Devgan asks his residents before allowing them to operate ensure that each resident has adequate knowledge and a strategic plan should a complication arise, ensuring that proper management will ensue regardless of the need. Additionally, these queries will help the residents better understand the rationale behind the instructions given during surgery. Even with the absence of a complication, this approach helps the residents to acquire a systematic way of thinking that will prepare them for any situation. I would like to encourage Dr. Devgan's approach and, further, to petition his recommendation of books or articles that could assist beginning cataract surgeons as they hone their surgical skills.

Mohamed Guenena, MD
Charleston, South Carolina

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