Course  Description

1stPhacoemulsification Simulators and Ophthalmic Microscopic  Wet-lab Course

12-17 December 2015 (1-6 Rabi Al Awal1437)

Speakers and Instructor Supervisors:

Course Organizer – Dr. Saeed Al Wadani

First day simulator and wet-lab objectives:

1. Demonstrate fine motor and proprioceptive skills under an operating microscope with ability to focus center of the globe.
2. Perform a continuous curvilinear capsulorhexis of appropriate size on the EYESI Simulator.
3. Describe the pedal settings on a phacoemulsification machine.
4. Learn the instruments used for cataract surgery.
5. Understand different categories of OVDs, their properties, preferred use.
6. Review the different types of ophthalmic suture and needles.
7. Understand principles of suture placement and needle passage.
8. Inject viscoelastic into the eye before IOL implantation or before capsulorhexis.

Supervisor Full Day              :           Dr. Saeed Al Wadani

Supervisor Alternating         :           Prof.Essam Osman, MD/Dr. Hatem Kalantan Resident Morning                  :           Dr. Mohammed Al Rajeh (R4)

Resident Afternoon               :           Dr.Nawaf Fawaz (R4)

Practical Session (HANDS-ON)

Ultrasound station will be conducted in Building 3 Level 1 Imaging Department Room 11 (with Rajah). No IOL/TOPO session on Saturday.

Second Day Objectives:

1. Demonstrate proper placement and length of corneal incisions.
2. Demonstrate paracentesis with a 3-step entry and proper placement of corneal incision that is neither too long causing corneal striae nor too short causing iris prolapse.
3. Demonstrate a scleral tunnel incision of adequate length and its 3 steps entrance procedure.
4. Demonstrate creation of a scleral tunnel of adequate length that does not cause decreased visibility through the cornea, neither entering into anterior chamber nor posterior, causing iris prolapse.
5. Understand the differences in phacoemulsification machines and settings.
6. Demonstrate the ability to create an adequate sized capsulorhexis with easy insertion of IOL and its good fixation on artificial and sheep eyes.
7. Understand principles of the technique and the difference between hydodissection and hydrodelineation.
8. Demonstrate the ability to do hydro-dissection, hydro-delineation using BSS.
9. Complete "groove" of appropriate depth, length, and width with minimal stress on zonules.
10. Crack nucleus and rotate nucleus with minimal stress on zonules.
11. Remove quadrants, taking care to keep quadrant in iris plane (away from capsule and endothelium).
12. Demonstrate the ability of load and inserting a 1-piece PCIOL into the capsular bag.

Supervisor Full Day              :           Dr. Saeed Al Wadani

Supervisor Alternating         :           Prof.Essam  Osman,MD/Dr.  Hatem Kalantan Resident Morning      :           Dr.WafiAnazi (R3)

Resident Afternoon               :           Dr. Othman Jarallah (R4)

Practical Session (HANDS-ON)

Ultrasound station will be conducted in Building 3 Level 1 Imaging Department Room 11 (with Rajah). No IOL/TOPO session on Saturday.

Third Day Objectives:

1. Successfully complete a cataract case, using appropriate phacoemulsification settings on the EYESI Simulator and artificial eyes.
2. Learn about IOL designs.
3. Understand principles of how to choose a lens for a patient.
4. Learn about different IOL formulas and biometry.

Supervisor Full Day                       :           Dr. Saeed Al Wadani

Supervisor Alternating                  :           Prof.Essam Osman/Dr. Hatem Kalantan Resident Morning          :           Dr.Danya Al Dahan (R4)

Resident Afternoon                           :           Dr. Saad Enazi (R3)

Practical Session (HANDS-ON)

Ultrasound station will be conducted in Building 3 Level 1 Imaging Department Room 11 (with Rajah). No IOL/TOPO session on Saturday.

Fourth Day:

The Residents should master the 1st, 2nd& 3rd day objectives

Supervisor Full Day                       :           Dr. Saeed Al Wadani

Supervisor Alternating                  :           Prof.Essam Osman/Dr. Hatem Kalantan Resident Morning          :           Dr.AdiOwaifeer (R3)

Resident Afternoon                        :           Dr. Hamad Al Sulaiman (R3)

Practical Session (HANDS-ON)

Ultrasound station will be conducted in Building 3 Level 1 Imaging Department Room 11 (with Rajah). No IOL/TOPO session on Saturday.

Five-Day:

Supervisor Full Day                       :           Dr. Saeed Al Wadani

Supervisor Alternating                  :           Prof.Essam Osman/Dr. Hatem Kalantan Resident Morning          :           Dr.Danya Al Dahan (R4)

Resident Afternoon                        :           Dr.Hanan Al Makhdoum (R3)

Practical Session (HANDS-ON)

Ultrasound station will be conducted in Building 3 Level 1 Imaging Department Room 11 (with Rajah). No IOL/TOPO session on Saturday.

Sixth Day Objectives:

See evaluation Form

By the end of the course, the applicant or trainee must pass MCQ’s and surgical skills evaluation to have surgical simulator and wet lab certificate from Saudi Commission for Health Specialties and King Saud University. Passing score at least 70%.

Development of Learning Outcomes in Domains of    Learning

Each of the domain of learning shown below indicate:

• A brief summary of knowledge or skill, the course is intended to develop.
• A description of the teaching strategies to be used in the course, for that knowledge or skill to be developed.
• Various methods of resident assessment to be used in the course in order to evaluate the learning outcomes in that concerned domain.

a.Knowledge  and  Cognitive Skills

1. Description of the knowledge and cognitive to be    acquired
   1. To identify the instruments and steps of phacoemulsification.
   2. To list the differences in phacoemulsification machines and settings.
   3. To understand the basic principles of phacoemulsification and fluid dynamics.
   4. To identify the viscoelastic, IOL and suture types.
   5. To list pre-­‐intra-­‐post-­‐operative cataract complications.
   6. To understand the formulas used to calculate IOLs.
   7. To understand the refractive effects of IOL positions in the eye (AC, sulcus, bag)
   8. To learn the use of appropriate sutures for various ocular tissues under different situations.
   9. To understand the differences between venturi and peristaltic machines.
   10. To understand the various settings of the phaco machine.
   11. To understand the role of povidone iodine in the prevention of endophthalmitis.
   12. To understand various uses of different kinds of viscoelastic.

(ii)Teaching strategies to be used to develop that knowledge and cognitive skills

1. Reading and lectures.
2. Self-­‐directed learning
3. Audio-­‐visual materials.

(iii)Methods of assessment of knowledge and cognitive skills acquired

1. Feedback and discussion during lectures, simulator and wet-­‐lab skill sessions  (formal evaluation)
2. Continuous Assessment Examination (Multiple Choice Questions).
3. Objective Structures Clinical Examination (OSCE).

b.Interpersonal Professional Skills, Responsibility and Psychomotor Skills

1. Description     of    the    interpersonal,    psychomotor    skills    and development of the capacity to carry   responsibility
   1. To demonstrate fine motor and proprioceptive skills under an operating microscope with an ability to focus center of the globe.
   2. To perform a centered curvilinear capsulorhexis of appropriate size on the EYESI simulator
   3. To successfully complete a cataract case, using appropriate phacoemulsification settings on the EYESI simulator.
   4. To demonstrate the ability to groove and crack a nucleus into 4 quadrants and to remove all 4 quadrants adequately, during segment removal
   5. To demonstrate the proper placement and length of corneal incisions
   6. To demonstrate paracentesis, with a 3-­‐step entry and proper placement of corneal incision that is neither too long causing corneal striae nor too short causing iris   prolapse
   7. To demonstrate a scleral tunnel incision of adequate length and a proper 3-­‐step entrance.
   8. To demonstrate the ability of inserting a 1-­‐piece and 3-­‐piece PCIOL into the capsular bag and into the   sulcus