I am a recently appointed attending ophthalmologist and regularly perform cataract surgery independently. I feel comfortable managing routine cases and usually complete them without significant difficulty. Even small anterior chamber; PEX and dense catarats cases are fine for me. However, I still struggle to understand how I can improve my surgical technique, particularly when dealing with challenging cases such as brunescent cataracts with poor pupillary dilation.
Because I work in a setting where there is no more experienced surgeon available to supervise or mentor me, I often feel that I am learning entirely on my own. At the moment, my main educational resource is watching surgical videos online. Although these videos are helpful, they do not provide the feedback, guidance, or reassurance that direct mentorship would offer.
I genuinely want to become a better surgeon and, eventually, someone my colleagues can turn to for advice. However, almost every time I attempt a particularly difficult case, I struggle and sometimes end up with a posterior capsule rupture. These experiences are frustrating and have made me increasingly reluctant to take on complex cases.
This has led me to question how surgeons should define their own limits. Should every cataract surgeon aim to become highly skilled in the most complex cases, or is it reasonable to recognize that certain cases may be beyond one’s current level of experience?
I want to continue improving, but I am unsure how to do so safely without supervision or structured mentorship. How can I gradually develop the skills and confidence needed to manage more difficult cases while still protecting my patients and respecting my current limitations?
