Ophthalmology residents need specific, dedicated programs focused on surgical training

During the last decade, ophthalmology has gained credit as a highly sophisticated surgical specialty. In the past, eye surgeons were among the first to use the operating microscope, and since then, the number of procedures, techniques and technologies have exploded and become more and more refined. Similarly, invasiveness has greatly decreased with the development of microincisions and local or even topical anesthesia. We are also asked to produce high volumes while reducing operating times. This is typically the case of cataract surgery, which evolved from intra/extracapsular extraction under general anesthesia with an inpatient regimen to phaco/femto under intracameral anesthesia/mydriasis with IOL implantation through a tiny incision of less than 2 mm in an ambulatory setting. More recently, the universe of vitreoretinal surgery has been revolutionized by the introduction of transconjunctival sutureless vitrectomy. Personally, my standard approach to complex retinal detachment is 27-gauge pars plana vitrectomy under panoramic viewing.Suddenly, operations that lasted hours with complex maneuvers can now be completed by a single surgeon and the OR nurse in less than 1 hour. Patients have also dramatically changed. They know that most conditions can be fixed with a high success rate and a perfect and timely recovery. Therefore, their expectations have increased and they are highly demanding.