Cataract surgery is the most commonly performed intraocular surgery performed in the UK. It takes years of meticulous practice and experience to master the surgery and become a safe and slick surgeon.
As the saying goes, “forewarned is forearmed.” Anticipating surgical challenges by thorough history taking and preoperative evaluation of the patient is key to successful surgery and also patient satisfaction. This foundation is crucial for any surgeon aiming to excel in intraocular microsurgery.
FOUNDATIONS OF INTRAOCULAR MICROSURGERY – Principles for Elite Performance Volume 1: Systemic Challenges is authored by two very well-known ophthalmic surgeons who have distilled their experience into six very readable chapters, which flow from one topic to the other in a logical and sequential manner.
The first chapter details both the common and uncommon systemic problems that our patients have, such as diabetes, obesity, claustrophobia, respiratory, and cardiac problems. It describes the challenges that the surgery may present, what to look out for in preoperative assessment, and gives very useful and innovative approaches to mitigate the issues intraoperatively and during the post-op period.
The second chapter provides insights on different systemic medications and how it can influence surgery. The book offers a detailed account of the consent process which is often overlooked in a busy practice and is relevant from the medicolegal perspective. I feel that a case scenario relating to ophthalmic microsurgery in the consent chapter of the book would have beautifully underlined the importance of that key process for the junior trainee surgeons and other healthcare professionals involved in the patient pathway.
The final chapter is about surgery in patients with cognitive impairment. It emphasises the importance of advance planning and treating each patient as an individual case. It delves in detail into capacity assessment and consent in this subgroup of patients and also the challenges that one may encounter during the patient’s pre-, intra- and postoperative journey. This emphasis on safety and risk mitigation underscores the author’s commitment to promoting excellence in surgical practice.
This is a very well-crafted, meticulous and comprehensive resource for both the novice and the experienced surgeon. For me, the highlight of the book was how the author specifically mentioned the systemic difficulties and the best way to manage them, and any related complications. This ensures that all readers would have the knowledge required to tackle such challenging situations with certainty.
To anyone who aspires to advance and excel in the art and science of intraocular microsurgery, I would highly recommend this book.
