Episodes

  • Managing the Disappointment of Poor Surgical Outcomes

    Managing the Disappointment of Poor Surgical Outcomes
    Dec 18 2024
    Rounding out this season’s theme of ‘Surgical Horror Stories,’ Jeffrey Whitsett, MD, joins Blake Williamson, MD, MPH, and Gary Wörtz, MD, to discuss his approach to managing the disappointment of poor surgical outcomes. He also shares a case example in which he encountered a complication during combination MIGS and cataract surgery, which resulted in a significant vitreous hemorrhage.. Drs. Whitsett, Williamson, and Wörtz also review the best ways to navigate potential horror stories in the business side of building a practice.
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    34 mins
  • Keeping Calm During Quicksand Moments

    Keeping Calm During Quicksand Moments
    Nov 25 2024
    Gary Wörtz, MD, and Blake Williamson, MD, MPH, invite Nicole Fram, MD, to share a surgical horror story in which a patient experienced light arcs, starbursts, and halos after silicone IOL implantation. Dr. Fram describes her approach to IOL exchange using a Collamer lens with a larger optic to manage the positive dysphotopsias. She reviews the complications she encountered during the procedure, including iris prolapse and iridodialysis, and describes her strategies for managing stressful surgical events.
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    41 mins
  • Cataract Surgery in a Severely Kyphotic Patient

    Cataract Surgery in a Severely Kyphotic Patient
    Oct 23 2024
    For the Halloween episode of this season’s surgical horror stories, Cathleen McCabe, MD, joins Gary Wörtz, MD, and Blake Williamson, MD, MPH, to share two uniquely challenging cases. In the first case, Dr. McCabe describes the time she performed cataract surgery on a kyphotic patient who was unable to lie on his back for the procedure. She explains her approach to positioning the patient and how she managed an additional unexpected complication. In the second story, Dr. McCabe discusses a patient with a difficult psychological history.
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    42 mins
  • Performing a Family Member’s Cataract Surgery

    Performing a Family Member’s Cataract Surgery
    Sep 24 2024
    Sebastian Heersink, MD, joins to contribute to this season’s theme of surgical horror stories. He talks with Blake Williamson, MD, MPH, and Gary Wörtz, MD, about his experience performing cataract surgery on his father and former guest of the podcast, Marnix Heersink, MD. Dr. Sebastian Heersink recounts how he managed the stress of operating on a family member, and how he approached a less-than-perfect result when the lens was slightly decentered on postop day 1, avoiding a potential horror story. He also discusses how he calms unhappy patients by validating their concerns and putting them at ease before surgery.
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    31 mins
  • Lensectomy Gone Awry

    Lensectomy Gone Awry
    Aug 21 2024
    Arsham Sheybani, MD, joins the podcast to continue this season’s theme of surgical horror stories. He shares a case example with Blake Williamson, MD, MPH, and Gary Wörtz, MD, in which he performed lensectomy in the eye of a 60-year-old woman who presented with angle-closure glaucoma and very high IOP. Following routine phacoemulsification, the anterior chamber began to shallow, eventually resulting in suprachoroidal hemorrhage. Dr. Sheybani also shares advice for communicating with patients about difficult, unfortunate outcomes.
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    32 mins
  • Expulsive Hemorrhage During Penetrating Keratoplasty

    Expulsive Hemorrhage During Penetrating Keratoplasty
    Jul 23 2024
    Continuing this season’s theme of surgical horror stories, Neda Shamie, MD, joins Gary Wörtz, MD, to share an experience from early in her career when she faced an unexpected complication. While performing penetrating keratoplasty on a well-known patient, Dr. Shamie encountered an expulsive hemorrhage. She highlights the value of mentorship in these situations and having a trusted colleague to help shape one’s approach to stressful complications during surgery. She also emphasizes the importance of learning from these situations and gaining new surgical skills.
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    40 mins
  • When Lightning Strikes Twice

    When Lightning Strikes Twice
    Jun 11 2024
    William Trattler, MD, joins Blake Williamson, MD, MPH, and Gary Wörtz, MD, to share a story in which a referring optometrist’s family member presented with dark brunescent cataracts in both eyes. He describes his initial approach and technique for managing these advanced cataracts, including the unexpected complication of a dropped lens and capsular bag tear in the first eye. Weeks after referring the patient to a retina specialist for an eventual good outcome, Dr. Trattler began surgery on the second eye, only to encounter a similar complication.
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    28 mins
  • Mitigating Potential Surgical Horror Stories

    Mitigating Potential Surgical Horror Stories
    May 20 2024
    Paul Walton, MD, continues the discussion with Blake Williamson, MD, MPH, and Gary Wörtz, MD, on approaches to anesthesia and nuances to manage potentially difficult patients during cataract and refractive surgery. Dr. Walton shares pearls to ensure a smooth day in the operating room, mitigating potential ophthalmology ‘horror stories.’
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    26 mins