Inaugural ANZ Microsurgical Course

The inaugural ANZ Microsurgical Course was held at the Sydney Eye Hospital from 25 – 27 October 2018. The two-and-a-half day course was attended by 19 doctors from around Australia and New Zealand.

The doctors themselves were either first year ophthalmology registrars or medical residents aiming for a career within ophthalmology. The course was a collaborative effort from the ophthalmology departments of the University of Sydney and University of Otago. Dr Graham Wilson of Gisbourne NZ (Clinical Senior Lecturer University of Otago and Principal Investigator, Vision, The Dunedin Study) has had the inspiration to set up this course for the last three years. The course has been modelled on the very well-known Royal College of Ophthalmologists Microsurgical course held 11 times each year and compulsory for all UK ophthalmology trainees.

The course was held in the Sight for Life Foundation Wet lab on level 2 North block of Sydney Eye Hospital. The world class training facility provided a number of innovations in training unique to the ANZ course. The attendees had access to human cadaver heads which provided the most authentic way of practising their surgical techniques. All students also trained on the Eyesi cataract surgery simulator to better assess their intraocular dexterity and skills. An educational grant from J&J surgical allowed for the purchase of 10 pharmabotics surgical skill boards. These boards allow for doctors to practise surgery on artificial skin and globes and were developed for the UK course. This was the first time such skills boards were used in Australia for training.

The course this year had the honour of inviting Mr Nigel Cox (Consultant Ophthalmologist in Great Missenden, Buckinghamshire) who set up the first UK microsurgical course in 1990 and has enormous experience in training residents and registrars in skills and approaches to microsurgery. He provided a number of lectures and course notes that greatly enriched the ANZ course. He had an excellent rapport with all attendees and we aim to invite him back again for future courses.

The skills taught and practised by all doctors included:

  • Wound repair on pigs eyes: lamellar corneal wounds, full thickness corneoscleral wounds, ruptured globe repairs
  • Oculoplastic techniques on human cadaver heads: lid wedge excision, periorbital anaethesia, skin excisions and flap repairs, subtenons anaethesia, peritomy, ocular muscle detachemnet and re-attachment, enucleation, tarsorrhaphy techniques, canthotomy and cantholysis
  • Cataract surgery using artifical eyes including IOL folding and implantation, draping and surgical antisepsis

The course had a teaching staff sourced from Australia and New Zealand. NZ supervisors included Dr Graham Wilson (Gisbourne), Dr Logan Mitchell (Dunedin), Paul Baddeley (Christchurch) and Oliver Comyn (Christchurch). Paul and Oliver are both UK-trained ophthalmologists who completed the UK course and provided unique insights into microsurgical teaching. Australian supervisors included Yves Kerdaron, Con Petsoglou and Simon Taylor, all from the University of Sydney with many years of teaching experience running wetlab sessions in the Sydney Eye Hospital training scheme. The ANZ course this year aimed for an intensive two-and-a-half days of supervised sessions with a high demonstrator to student ratio of 1:3 at all times. The course was supported by an online series of 10 lectures on all aspects of microsurgery that opened to course participants four weeks prior to the hands-on course commencing.

The course this year could not have been completed or as successful without the support from industry. We particularly appreciate the support of Johnson & Johnson Surgical, Alcon Surgical and Zeiss Australia. Johnson & Johnson Surgical surgical provided the artificial eyes, two phacoemulsification machines and all consumables, the ten surgical practise boards, meals for all sessions and a textbook on cataract surgery for all trainees. Alcon provided four cataract machines with consumables and held a course dinner at Lotus restaurant. Zeiss provided two additional microscopes to make for ten microsurgical workstations. The Sight for Life Foundation provided incredible onsite support and consumables to ensure the smooth running of the course.

The Universities of Sydney and Otago expect to hold the course twice a year, given the success of this first course, outstanding feedback from attendees and demand for places. It was encouraging to see the progress all the trainees gained during the two-and-a-half intensive days. Though demanding for all involved, it was a worthwhile teaching effort that will definitely benefit enrolled doctors and their future patients.

To register your interest in attending a future course, please send an email to Jonna@SFLF.org.au.

Share this post

The Sight for Life Foundation’s objectives are to preserve and enhance vision throughout life. The Foundation is a national charity with deductible gift recipient status.

Street Address

Sight for Life Training Lab
2nd Floor, North Block
Sydney Eye Hospital
8 Macquarie St, Sydney NSW 2000

PH: (02) 9234 1999

Office Hours

Monday to Thursday 8:00am – 4:00pm

How to Find Us

© Sight For Life Foundation 2023. All rights reserved.

DIRECTIONS BY TRAIN

You’re only either a 2 minute walk or a 5 minute walk away

The training lab is a two minute walk from Martin Place train station and a five minute walk from St James train station. You can easily plan your trip via the button below.

There is also a direct line from the airport to St James Station with a travel time of around 15 minutes.

DIRECTIONS BY CAR

There is street parking available at the rear of the hospital on Hospital Road

Located under the hospital is Point Parking, which is accessible on Hospital Road. The park house is open weekdays from 6:30am – 9:30pm, Saturdays from 8:00am – 8:00pm and on Sunday from 9:00am – 6:00pm. For further information, please visit their website.

A short walk away is the Wilson Domain Car Park. For further information, please visit their website.

RIGHTS & RESPONSIBILITIES

The Australian Charter of Healthcare Rights are essential to make sure that wherever and whenever care is provided it is of high quality and is safe.

The Charter recognises that people receiving care and people providing care all have important parts to play in achieving healthcare rights.

The Charter allows patients, consumers, families, carers and services providing health care to share an understanding of the rights of people receiving health care. This helps everyone to work together towards a safe and high quality health system. A genuine partnership between patients, consumers and providers is important so that everyone achieves the best possible outcomes.

These three principles describe how this Charter applies in the Australian health system.

  1. Everyone has the right to be able to access health care and this right is essential for the Charter to be meaningful.
  2. The Australian Government commits to international agreements about human rights which recognise everyone’s right to have the highest possible standard of physical and mental health.
  3. Australia is a society made up of people with different cultures and ways of life, and the Charter acknowledges and respects these differences.

The Sight Foundation theatre is committed to providing the best possible patient care. As a patient you have certain rights and responsibilities. This is outlined in the Australian Charter of Healthcare Rights.

For further information please visit: www.safetyandquality.gov.au

ACCESS

Right: I have a right to health care.
Meaning: I can access services to address my healthcare needs.

SAFETY

Right: I have a right to receive safe and high quality care.
Meaning: I receive safe and high quality health services, provided with professional care, skill and competence.

RESPECT

Right: I have a right to be shown respect, dignity and consideration.
Meaning: The care provided shows respect to me and my culture, beliefs, values and personal characteristics.

COMMUNICATION

Right: I have a right to be informed about services, treatment, options and costs in a clear and open way.
Meaning: I receive open, timely and appropriate communication about my health care in a way I can understand.

PARTICIPATION

Right: I have a right to be included in decisions and choices about my care.
Meaning: I may join in making decisions and choices about my care and about health service planning.

PRIVACY

Right: I have a right to privacy and confidentiality of my personal information.
Meaning: My personal privacy is maintained and proper handling of my personal health and other information is assured.

COMMENT

Right: I have a right to comment on my care and to have my concerns addressed.
Meaning: I can comment on or complain about my care and have my concerns dealt with properly and promptly

  • Find out about your condition and treatment and ask questions of relevant health service providers
  • Know your medical history and provide accurate personal information
  • Cooperate with the doctor and nursing staff caring for you
  • Provide health fund details prior to admission or alternatively make full payment on the day of surgery
  • Respect the rights of other patients.

The Sight Foundation Theatre has appointed a Privacy Officer to ensure that your information is collected, stored and used in compliance with the Australian Privacy Act 1988 and Privacy Amendment Act 2012.

  • The SFT Privacy Policy is located on the website and information is also provided to patients in the Patient Information Brochure. Patients can request a written copy of the SFT Privacy Policy or it can be printed from the website.
  • The Centre collects personal information that is necessary to provide an effective service focussed on optimum patient outcomes to plan appropriate treatment and care for the individual.
  • The information is collected from the individual and/or carer, relative, medical practitioner and other allied health providers.
  • Security safeguards are in place in the SFT to protect health information. Such safeguards include care of individual information whilst that individual is receiving treatment and on discharge from the Centre. Comprehensive policies and procedures, in relation to the management of clinical records in accordance with Australian and national Standards, are in place to guide our staff.
  • All patient records are confidentially stored in line with acceptable standards.
  • Periodic reviews and audits are undertaken to monitor compliance in standards.
  • Patients must identify themselves in line with Medicare or their health fund.
  • Personal information may be discussed where legally required, e.g.: submission of data to the NSW Ministry of Health or Commonwealth Health Department.
  • Additional use of information, if consent is obtained from the individual, includes: informing the next of kin of treatment outcomes, to obtain consent for necessary treatment when the individual is unable to provide such consent.
  • Personal information about our patients will assist in the development of service delivery and planning of the Centre, undertaking of quality activities, research and development projects or for education purposes.
  • The Centre will take reasonable steps to ensure that the information collected, used or disclosed is accurate, complete and up to date. At all times, the SFT will respect and protect the privacy and confidentiality of personal information. Each patient is able to access their personal information and upon request will be provided with a release of information consent form that is retained as a permanent part of the record relevant to a particular admission.
  • Patients are able to contact the Clinical Service Manager if they wish to view or correct their personal information.
  • Patient consents include an opportunity for patients to identify persons to whom we can disclose personal information.

PROCEDURES

The Sight for Life Foundation Theatre performs cataract surgery, glaucoma procedures including trabeculectomy, Minimally Invasive Glaucoma Surgery (MIGS)), Descemet Membrane Endothelial Keratoplasty (DMEK) procedures, pterygiums, corneal transplants and oculoplastics. Contact your surgeon to discuss what operation is appropriate for you. 

 Equipped with the latest technology, highest standard of instrumentation and clinical staff, the Sight Foundation Theatre truly is a centre of ophthalmic excellence.

PATIENT CENTRED CARE

We aim to maintain the highest levels of safety and quality in providing care to our patients in a patient centred, caring, safe and supportive environment

Our centre adheres to all statutory, legislative, relevant body guidelines and Australian Standards. To achieve a high standard of care we work together as a team under the management of the Board of Directors, Medical Advisory Committee and Director of Nursing within the following functions

Sight Foundation Theatre has a well developed safety and emergency procedure in which each staff member has a key role. In the unlikely event of an emergency, remain where you are until a staff member arrives to assist you.

A medical record will be kept of your admission and treatment. This will be confidential with access being limited only to the healthcare professionals directly involved in your treatment. This record will remain the property of the hospital. The contents of your medical record will be divulged only with your written consent, or where required by law. You may request to review your medical record at any time.

The doctor who admits you is responsible for your medical care while you are in hospital. Any questions that you have regarding your treatment should be directed to him or her.

In accordance with the Department of Health Policy, smoking is not permitted anywhere on the hospital campus. It is recommended that you do not smoke before and after your procedure.

A comprehensive program to monitor, assess and improve the quality of patient care.

Peer review activities are conducted by the Medical Advisory Committee to ensure that the safest possible care is provided to our patients.

As part of this process we publish information in a newsletter about clinical performance, health outcomes and patient satisfaction. This information is also benchmarked against national standards, where applicable.

Through the use of a detailed ophthalmic clinical pathway our patients receive specialised ophthalmic care. We would very much like to hear our patient’s views that we could use to improve our service.

The Sight Foundation theatre uses an integrated approach to identify, assess, analyse, evaluate, treat, measure, monitor and control the complex array of risks involved in health care. We take a proactive approach, placing the emphasis on risk prevention to provide the safest possible environment for patients, visitors and staff.

The Sight Foundation theatre has a comprehensive Infection Control program aimed at preventing and limiting the spread of infection through evidence based research to guide clinical practice.

Our program consists of education for all stakeholders including auditing of staff practices, infection prevention measures, surveillance, monitoring and investigation of health care associated infections.

Our management and staff make every effort to ensure the environment is safe and comfortable for all who visit our Centre. Infective agents may be transmitted by several routes. If you have a current illness or a non-healing/ed wound, this has the potential to adversely affect your surgical outcome. In such a situation, a clearance may be required from your doctor and any wounds or breaches of skin integrity, e.g. ulcers, will need to be covered by an occlusive dressing.

We employ dedicated specialist clinical staff members to ensure our patients receive the highest standard of care possible in a comfortable and safe environment.

The Sight Foundation theatre undertakes planned and regular biomedical testing and maintenance of its equipment and plant. Audits are conducted on a frequent basis to ensure the environment is safe for all who visit the facility.

MENTAL HEALTH 

Staff are alert to the risk of deterioration in mental state, are able to recognise deterioration in a person’s mental state, initiate response, and escalate care. The response to deterioration in a person’s mental state is person-centred and culturally competent. Decision making is shared. Family and carers are involved in accordance with the person’s expressed wishes. Appropriate risk management strategies are implemented.

 

COMPREHENSIVE CARE

“We” includes you and your family in the process and strive to provide the best outcome for all.

Our  robust pre admission screening and  clinical alert system highlight patient care processes throughout your admission. We identify your individual needs thus prevent harm related to falls, pressure injuries, nutrition, mental health, cognitive impairment.

If you have  any concerns or questions, please contact us prior to your admission to discuss your or your loved ones needs.  

HELPFUL INFORMATION

Sometimes it is difficult to take in all the information about your procedure, so below is some information that may help with your recovery and general health.

At the time of your initial presentation for your procedure at the Sight Foundation Theatre, our staff members will confirm your name, birth date and doctor. Do not be alarmed if at each stage of your care our staff members confirm your name, birth date, proposed procedure and side. These patient identification checking procedures are for your protection, however please note that our staff are aware of who you are but must ensure the identification procedures are carried out.

Hand hygiene is an essential key strategy in the prevention and control of healthcare associated infections. Good hand hygiene practice also protects the Sight Foundation Theatre’s workforce and our consumers. Hand hygiene education and audits are conducted at the Sight Foundation Theatre and our patients are provided with an information sheet on hand hygiene at the time of discharge. If you require any information on hand hygiene please ask one of our clinical staff.

Almost every patient at the Sight Foundation Theatre receives medication during their day surgery stay. It’s very important to us to ensure that all patients receive the most appropriate medications accurately and safely, and to prevent mistakes in medication management. The Medical Advisory Committee reviews our medication systems and implements improvements as required to ensure medication safety.

Many drugs can affect your balance and judgment. For this reason, we will assess your likelihood of a fall post procedure and require you to have a carer with you after your procedure.

If you have a history of falls, or you are highlighted as a falls risk, we may conduct a further assessment and delay your discharge to minimise the risk of a fall after you leave our facility.

Please ensure that someone stays with you for 24 hours after your procedure. If you have a patch over one eye postoperatively it will be more difficult for you to judge distances. Vision is very important for your balance and reduced vision increases your risk of falling.

Clinical handover refers to the transfer of professional responsibility and accountability for some or all aspects of care for patients when they are transferred from one person to another. The clinical leaders and senior managers of the Sight Foundation Theatre have implemented systems for the effective and structured clinical handover of our patients. The doctors and nurses looking after you during your episode of care will use these systems to ensure that you are safe and well cared for through the different points of care whilst at the Sight Foundation Theatre.

Our patients and carers are encouraged to be involved in the clinical handover process particularly when they are discharged to go home. Should you have any concerns about the clinical handover process clinical staff must be informed.

Even though your time with us is limited and your procedure will be short in duration, we would like to provide you with some information about pressure injuries and how they can occur.

Skin Integrity

Promoted by good nutrition and activity, good hygiene, being aware of your surroundings and keeping your skin from becoming dry and chaffed.

Pressure Injuries

Caused by unrelieved pressure that damages the skin and underlying tissue. They usually occur over a bony prominence as a result of pressure, shear, friction, or a combination of these factors. If you are unable to move freely, have limited control of bladder or bowel, poor nutrition or lowered mental awareness, these may increase your possibility of developing pressure defects.

On admission we will assess your skin and, if necessary, provide you with relevant positioning aids to prevent these from occurring whilst in our care.

The Sight Foundation Theatre has established and maintained systems for recognising and responding to clinical deterioration in our patients. The patient centred care pathways and staff emergency training will therefore ensure that our patients’ needs are met and they are safe during their episode of care.

However, in the unlikely event that a patient or a carer should notice any sign/ symptom of clinical deterioration, clinical staff must be advised of any concern which may be relevant to the patient’s condition.

If you have an Advance Care Plan, please bring a copy with you for our records.

An Advance Care Plan is a legal document that enables you to give instructions about your health care, including special health matters, when you are no longer able to make a decision for yourself. An Advance Care Plan allows you to make specific directions about the care you will want and under what circumstances. The directions in an advance care plan can be very detailed, or they can be broad, outlining your beliefs and values about end of life matters.

If you have one of these in place, please bring a copy with you. If you are interested in obtaining an Advance Care Plan, you can buy this form from a post office or newsagency.

ANAESTHESIA

This can be an anxious time for you, so we would like to reassure patients that they are in good hands during this time

Anaesthetists in Australia are specialised doctors who are highly trained in administering anaesthesia, as well as pain control, resuscitation and managing any medical emergency.

Your anaesthetist will see you before your procedure, allowing you the opportunity to discuss any concerns. It is important that you disclose everything that you think is relevant and follow your medical and fasting instructions. Your anaesthetist will monitor you during the procedure and after surgery is finished to ensure a smooth and trouble-free recovery.

Developments in new surgical techniques combined with modern anaesthesia result in a more rapid patient recovery – making day surgery preferable to overnight hospitalisation. The following is an explanation of the various options of anaesthesia that may be used in day surgery.

Eye drops that numb the surface of the eye may be used. Sedative drugs may or may not be administered according to need. The patient is awake and recovery is quick.

A local anaesthesia is administered prior to surgery to cause numbness. You will be awake, but comfortable and not feel any pain.

A nerve block numbs the part of your body where the surgeon operates and this avoids the use of general anaesthetic. Like the above methods, you will be awake but comfortable and not feel any pain.

To make things more pleasant during your stay, your anaesthetist may intravenously administer a drug to make you relaxed and drowsy.

The advantage of the above methods of anaesthesia is that as soon as the operation is finished the patient is usually ready for something to eat and drink and discharge generally takes place within the hour.

You are put into a state of unconsciousness for the duration of the operation. This is achieved by injecting a drug, or drugs, through a needle placed in a vein and is combined with a mixture of gases that you will breathe. The anaesthetist monitors your condition closely while you remain unaware of your surroundings. Recovery time will be longer with a general anaesthetic.

IMPORTANT MESSAGE:

Although the drugs administered are given in the smallest effective doses, they may take a while to be eliminated from your body due to different rates of metabolism. It is therefore imperative that you do not drive, work machinery or sign important documents for 24 hours following the procedure.

DAY OF SURGERY

Today is your big dig day! It is important that you know are comfortable and informed of the steps leading up to your surgery.

These are general fasting rules, unless otherwise advised. Please telephone our nursing staff if you have any queries.

  • Adults who have morning surgery are requested not to eat or drink after midnight the night before their surgery.

  • If your surgery is in the afternoon, have breakfast but do not eat or drink after 7am unless otherwise advised during your pre-admission phone call.

  • Veterans’ Affairs patients must provide the Centre with their Gold Card number and bring the card at time of admission.
  • Any relevant forms that you may still have for the Sight Foundation Theatre.
  • Your fund card will only be required if you have not supplied your fund details.
  • esults of any relevant tests completed prior to admission.

Our friendly reception staff will finalise your admission and account, and any other necessary details, on arrival.

  • A nurse will welcome you into the clinic where you can relax in a comfortable chair.

  • Observations and a medical history will be taken by our nursing staff.

  • Your privacy and confidentiality is retained and respected at all times

All procedures require recovery time and this depends on the individual patient. the average stay is approximately 2-3 hours depending on your procedure.

  • Patients are offered light refreshments before leaving the Centre.

  • Following anaesthesia, you are to be accompanied home by a responsible adult and have someone to stay with you on the night of surgery. We advise that you must be transported home by private car or taxi and not on public transport.

  • A 24-hour instruction sheet will be given to you on discharge.

  • You may be required to visit your surgeon the following day.

  • You will receive a courtesy phone call from our nursing staff the following day.

  • You may have an eye pad covering your effected eye. This may affect your depth perception and increase your falls risk. Therefore it is important to have a responsible adult accompany you home.

PREPARING FOR SURGERY

The pre admission stage of your day surgery care is very important and will assist to ensure you have a positive experience.

There are a number of things you can do to ensure you are adequately prepared for your admission.

Please read the information on this website very carefully. Your ophthalmologist will explain your procedure/operation and complete the consent form with you.

  • Your ophthalmologist will also advise the Centre of the date of your admission. Your ophthalmologist may also request that you undergo a general health assessment with a general practitioner.
  • Should there be a change in your condition or you develop a cold or illness prior to your surgery please advise your ophthalmologist or our Centre.
  • All patients must have a carer present on the night of surgery. Carers will be asked for an accessible contact number.
  • If you are coming from outside Sydney, please supply the Centre with your contact details.
  • If you are taking Warfarin or Clexane medication, it is important that you provide the Centre with a recent INR blood test result taken a few days prior to admission.
  • Doctors, specialists, and anaesthetists will send you separate accounts that may not be paid at our Centre.
  • If pathology is taken whilst in our care, you will receive a separate account

If you have difficulty with understanding English, please get the support of a competent person to translate for you and assist with your visit to the Centre.

You will receive a phone call up to 24 hrs before your surgery, advising you of your fasting and admission times. If you are not English speaking please organise for someone with good English skills to contact us on your behalf.

Assistance is also available from the translation and Interpretation Service (TIS) on:

1800 131 450.

There are general fasting rules, unless otherwise advised. Please telephone our nursing staff if you have any queries.

  • The nurse will contact you with your time to arrive.
  • Please fast from food for 6 hours before admission and water 2 hours before this admission time.

In accordance with the NSW Health policy, the Sight Foundation Theatre is a smoke free environment.

  • To achieve a better outcome, it is advised that you do not smoke prior to your surgery or immediately after.
  • Alcohol should not be consumed prior to surgery as it could interact with some medications.

Please do not bring any valuables as the Centre is not able to take any responsibility.

Please follow any pre admission instructions given to you by your doctor.

Drop off from Hospital Road
Domain car park
Sydney Eye Hospital (Metro Parking)

If accompanying a patient you may wait in our comfortable waiting area. Alternatively we will ring when the patient is ready to leave.

It is important that you advise us if your weight is greater than 120 kg as it may not be advisable for you to have your procedure at our Centre.

Please complete the pre admission and patient history forms.

You must include a current physical address not a P.O. Box on the Pre Admission Form paperwork. These forms will allow us to confirm your admission and financial and other arrangements. Please forward the completed forms to the Centre as soon as possible so that your day surgery booking can be confirmed:

In person:

Sight Foundation Theatre, Level 3, Sydney Eye Hospital, 8 Macquarie St, Sydney

Fax to:

02 9223 8299 and bring the originals on the day of surgery

Mail to:

Sight Foundation Theatre, GPO Box 2684, Sydney NSW 2001

Email a scanned copy to:

info@sflf.org.au


If your account is handled through Workcover or a Third Party Claim, please provide us with the full details of your claim, including a letter from the insurer accepting liability for your admission.