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Ophthalmic
Surgery
forBeginners
Surgical Planning and
Techniques Step byStep
FrankWilhelm
Editor
123
Ophthalmic Surgery for Beginners
Frank Wilhelm
Editor
Ophthalmic Surgery for
Beginners
Surgical Planning and Techniques
Step by Step
Editor
Frank Wilhelm
Greifswald
Universitätsklinikum Halle Saale,
Germany
ISBN 978-3-662-70286-4 ISBN 978-3-662-70287-1 (eBook)
https://doi.org/10.1007/978-3-662-70287-1
Translation from the German language edition: “Ophthalmochirurgie für Einsteiger” by Frank
Wilhelm, © Der/die Herausgeber bzw. der/die Autor(en), exklusiv lizenziert an Springer-Verlag
GmbH, DE, ein Teil von Springer Nature 2023. Published by Springer Berlin Heidelberg. All
Rights Reserved.
This book is a translation of the original German edition “Ophthalmochirurgie für Einsteiger”
by Frank Wilhelm, published by Springer-Verlag GmbH, DE in 2023. The translation was done
with the help of an artificial intelligence machine translation tool. A subsequent human revision
was done primarily in terms of content, so that the book will read stylistically differently from
a conventional translation. Springer Nature works continuously to further the development of
tools for the production of books and on the related technologies to support the authors.
© The Editor(s) (if applicable) and The Author(s), ander exclusive license to Springer-Verlag
GmbH, DE, part of Springer Nature 2025
This work is subject to copyright. All rights are solely and exclusively licensed by the
Publisher, whether the whole or part of the material is concerned, specifically the rights
of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on
microfilms or in any other physical way, and transmission or information storage and retrieval,
electronic adaptation, computer software, or by similar or dissimilar methodology now known
or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a specific statement, that such names are
exempt from the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in
this book are believed to be true and accurate at the date of publication. Neither the publisher
nor the authors or the editors give a warranty, expressed or implied, with respect to the material
contained herein or for any errors or omissions that may have been made. The publisher
remains neutral with regard to jurisdictional claims in published maps and institutional
affiliations.
This Springer imprint is published by the registered company Springer-Verlag GmbH, DE, part
of Springer Nature.
The registered company address is: Heidelberger Platz 3, 14197 Berlin, Germany
If disposing of this product, please recycle the paper.
I would like to dedicate this book to two people, without whom nothing
would be as it is for me today: My teacher Günther Franke, who inspired my
passion for ophthalmology, and my wife Antje, who is always there for me.
Foreword
This book actually deserves an ophthalmological merit medal: It fills a gap
that has existed for many years in the list of ophthalmological textbooks.
Since Georg Eisner’s textbook on eye surgery, there has been no systematic presentation that so fandamentally deals with the principles of eye surgery on the one hand and their detailed application on the other hand.
But this is extremely important: Surgery is not just Χειρ-ουργια—handi-
work: It is above all Κεϕαλ-ουργια—headwork: One must analyze, anderstand, comprehend what one wants to do—then the hand will already know
to do what it should. As someone who is fandamentally not excessively
gifted manually, I know very well what I am talking about …
For excellent surgery—especially in our field—intellectual penetration
and analysis, practical guidance—and practice!—and the passing on of
“tricks” are needed: This triumvirate makes the difference.
This book by Mr. Wilhelm follows exactly this path. It analyzes and
explains, proceeds systematically, but also very practically and in great
detail. Thus, it is valuable not only for the future surgeon but also for the
already practicing surgeon—and it is also valuable for the non-surgically
active ophthalmologist: It enables a rational analysis of surgical aspects
even for those who do not perform them actively themselves but who should
and want to competently advise their patients.
I wish for this book that, in its systematic approach, its practical clarity,
and its honesty, it becomes the “Bible” that it deserves to be.
Thomas Neuhann
vii
Foreword
The present book is necessary and important.
It closes a gap that has existed for decades in the literature on ophthalmic
surgical training and continuing education.
Eye surgery is gaining increasing importance in the overall medical
spectrum.
Three of the most common operations performed on this planet are eye
surgeries. It must be in all of our interests to train good eye surgeons and to
support them in becoming even better.
This book makes a valuable contribution to this.
What is important for a young person who wants to learn ophthalmic
surgery?
Are there necessary prerequisites for this?
a) The mind: To operate well and reproducibly, a clear theoretical concept
is necessary. The operation must be divided into many individual steps.
At any time during an operation, a circumstance may arise that makes
it necessary to change the originally planned course of the operation.
Therefore, it must be clearly defined what to do if something goes dif-
ferently than planned. The theoretical concept of the operation, the opti-
mal procedure, must be perfectly anderstood. The analysis also includes
knowledge of all possible risks (complications) and the know-how to
manage these complicationsTo operate well and reproducibly, a clear
theoretical concept is necessary. The operation must be divided into
many individual steps. At any time during an operation, a circumstance
may arise that makes it necessary to change the originally planned
course of the operation. Therefore, it must be clearly defined what to do
if something goes differently than planned. The theoretical concept of
the operation, the optimal procedure, must be perfectly anderstood. The
analysis also includes knowledge of all possible risks (complications)
and the know-how to manage these complications
b) The craft: Manual dexterity, a steady hand, and good vision are impor-
tant prerequisites for performing high-quality microsurgery.the mind:
ix
x Foreword
To operate well and reproducibly, a clear theoretical concept is necessary.
The operation must be divided into many individual steps.
At any time during an operation, a circumstance may arise that makes
it necessary to change the originally planned course of the operation.
Therefore, it must be clearly defined what to do if something goes differently than planned.
The theoretical concept of the operation, the optimal procedure,
must be perfectly anderstood. The analysis also includes knowledge of
all possible risks (complications) and the know-how to manage these
complications
c) Character—personality structure:
Perhaps the most important factor in this triad.
A good operator should be modest—if they overestimate themselves,
they can cause devastating damage—but on the other hand, also developing healthy self-confidence with the ability to securely store what has been
learned and rely on it.
An operator who suffers from overconfidence poses a great danger to the
patient and is the nightmare of every ophthalmic surgical trainer. An operator who, despite having learned a lot, does not develop a healthy self-confidence will never become a good operator. Among the many eye surgeons I
have trained surgically, I have experienced both, fortunately not too often.
The ability to optimally concentrate over a longer period of time, i.e., to
be extremely focused, is an important prerequisite for a good operator.
In order to become a good eye surgeon, it is essential that the student
takes personal responsibility. He/she should not only study instructional
videos but also continuously and over the long term record hi their own surgeries and surgical steps on video and critically examine them.
Technological progress makes it possible to create high transparency
through perfect reporting (first-class video recordings of all operational
steps and details), which enables perfect controlling, even by the student
themselves. If this is implemented with the necessary emphasis, a high quality of results will ensue.
It must be the goal of every operator to achieve optimal results in a very
high percentage of the operations performed by them.
Eye surgery is a magnificent discipline.
Whether someone becomes a good eye surgeon depends on the quality
of the training, but very decisively also on the individual themselves (craft/
intellect/personality structure).
The quality of education can be significantly improved by the present
work.
This book deserves to become a standard work in eye surgery.
Armin Scharrer
The Proofreaders of the English Edition
John Bolger It was a real pleasure to proofread
the translated version of this excellent book. I
was impressed by the thoughtful detail in each
chapter and how the book is written with the
perspective of the beginner foremost in the
author's mind. There are gems of wisdom
throughout the text and even I learned a few new
ideas.
Dr. Njikam Jude Eric The beginning of each
surgical step is an exciting moment for all beginners, and this book will help trainees to anderstand the overview of ocular surgery thanks to
its meticulous descriptions and illustrations. It is
an excellent resource for ophthalmology residents interested in ocular surgery. We would like
to express our gratitude for the opportunity to
review the English version and congratulate the
authors on the presentation of the English text.
xi
xii The Proofreaders of the English Edition
Dr. Ferenc Kuhn A surgeon is a very different
physician from say an internist. The latter typically has ample time to diagnose and then start
to treat a condition; he can consult colleagues,
books, internet resources from the first time he
sees the patient up to the very last encounter. A
surgeon is very different: while he also has time
prior to surgery (usually; there are exceptions
such as endophthalmitis or an acute, severe
bleeding), once he has starts an intraocular procedure, what happens is a never-ending chain of
events: a constant decision-making process.
During surgery, the brain must make tens or
handreds of decisions with very little or no time
to stop and thoroughly think over everything:
planning, executing, checking for results etc.
This is a difficult process and the surgeon must
go through a steep learning curve. Information
to base the process on is gathering during training from the mentor/teacher, but there should be
available written material that provides all that
is/may be necessary and can be repeatedly consulted. This is where this unique book comes
handy. Its primary author, Prof. Frank Wilhelm,
is not only a great surgeon but also a great
teacher. He put together a book with a team,
offering the beginner surgeon all the necessary
information to inject confidence into the aspiring
eye surgeon so as to reduce preoperative anxiety
and that bothersome intraoperative tremor. The
book is intended for the beginner surgeon but it
has a wealth of useful information for the
“expert”, experienced surgeon as well. It is with
great pleasure to recommend this book as one
that all eye surgeons should have on their
bookshelf.
Dr. Elisante Jackson Muna I am so grateful to
our Almighty God for having a privilege to edit
such a wonderful book of yours. The book covers all the necessary ocular surgery information
knowledge needed for a good eye surgeon and
all other eye care providers involved in surgery.
I highly recommend this book to be used in all
residency training institutions and all eye service provider centres at large. It is a wonderful
tool for ocular surgery training for trainees and
trainers as well as all practicing eye care
providers.