Ergonomics in strabismus surgery

Bonafede, Lucas; Kazmierczak, Lisa; Siddicky, Safeer F.; Gunton, Kammi B.

doi:10.1097/icu.0000000000000594

Cited by 4 publications

(11 citation statements)

References 26 publications

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“…After undergoing training, all eight participants demonstrated an increase in the percentage of time spent upright (►Fig. 1). Across all participants, the total average percentage spent upright in the observation period was 59.8%, while in the testing period was 87.1%, resulting in an average improvement of 27.3% of time spent in an upright position after the completion of the training period (p < 0.0001).…”

Section: Resultsmentioning

confidence: 95%

“…Ophthalmologists are at a significantly higher risk for work-related musculoskeletal disorders (MSDs) compared with nonsurgical physicians due to the dexterous, lengthy nature of microsurgeries. 1 2 3 4 5 6 The repetitive movements and sustained contractions experienced while operating slit lamp biomicroscopes, loupes, and indirect ophthalmoscopes impart increased postural stress in up to 87% of surveyed ophthalmic surgeons. 1 2 4 5 7 8 The subsequent pain and discomfort can affect not only the surgeon's health, but also that of their patients.…”

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confidence: 99%

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Ergonomics of Ophthalmic Surgery: Evaluating the Effect of a Posture Trainer on Trainee Intraoperative Back Posture

Markatia,

Al-Khersan,

Kalavar

et al. 2023

Journal of Academic Ophthalmology

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Purpose Ophthalmic surgeons are at an increased risk for musculoskeletal disorders resulting from ophthalmology-specific routines and equipment, which have become widely associated with poor posture. The purpose of this study was to observe the effect that a commercially available posture trainer, Upright Go, can have on the improvement of posture of ophthalmic surgeons. Methods Eight ophthalmologists-in-training were studied over a period of 4 weeks during their surgical rotations between September 2020 and June 2021. Participants underwent an “observation” period, followed by a 2-week “training” period, then a final “testing” period. The percentage of time users spent upright intraoperatively pre- and posttraining was evaluated. Pre- and poststudy surveys were also administered to help measure participant satisfaction and self-reported changes in posture. Results All eight participants demonstrated an increase in the percentage of time spent upright after the training period. Across all participants, the total average percentage spent upright in the observation period was 59.8%, while in the testing period was 87.1%, resulting in an average improvement of 27.3% of time spent in an upright position after the completion of the training period (p < 0.0001). The range of improvement of time spent upright was 16.0 to 46.5%. Conclusion This cohort study utilized the Upright Go device to help determine the effect that its training could have on the improvement of posture in ophthalmic surgeons. The results indicated a significant increase in the average proportion of time spent with upright posture compared after the training period.

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Section: Resultsmentioning

confidence: 95%

mentioning

confidence: 99%

Ergonomics of Ophthalmic Surgery: Evaluating the Effect of a Posture Trainer on Trainee Intraoperative Back Posture

Markatia,

Al-Khersan,

Kalavar

et al. 2023

Journal of Academic Ophthalmology

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“…In a recently published article, the authors reported that pediatric ophthalmologists are prone to developing MSD because of the repetitive movements and awkward positioning required for strabismus surgery. 13 Hyer et al performed an extensive survey on the United Kingdom ophthalmologists to determine the prevalence of MSD. Of their 518 replies, 50.6% reported back pain, 31.8% reported neck pain, and 62.4% reported having both.…”

Section: Discussionmentioning

confidence: 99%

The Prevalence of Work-Related Musculoskeletal Disease Among Pediatric Ophthalmologists

Jain

Akhter

Ishihara

et al. 2022

OPTH

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Introduction Work-related musculoskeletal disease (MSD) is the second leading cause of disability globally. Ophthalmologists widely report MSDs in the neck (70%) and back pain (40–80%). Our study intended to identify the prevalence of MSDs among pediatric ophthalmologists. Methods Pediatric ophthalmologists self-reported chronic pain, instrumentation used, years practiced, surgeries performed, work schedule/environment modifications due to MSD, and treatment for MSD via an anonymous online survey. Statistical analysis of responses included odds ratios, Pearson chi-square testing, and Spearman correlations. Results This study had 101 respondents, with 66% reporting chronic pain. Chronic neck pain (41%) and lower back pain (31%) followed by shoulder pain (30%) were the leading MSD complaints and significantly correlated with years of experience (p<0.05). Participants often had multiple types of pain, including 13% of the sample who experienced all three types of pain. Those reporting shoulder and back pain also reported a greater incidence in work modification (68–83%). Those suffering from chronic neck, shoulder, and lower back pain have sought treatment for their MSD (p<0.05). Discussion With such wide reporting of chronic neck, back, and shoulder pain, the development of MSDs likely leads to disability. Ergonomic innovations in the workplace may reduce the healthcare burden and prolong pediatric ophthalmologists’ ability to provide services. Conclusion In our study, the reported prevalence of chronic neck and back pain was comparable to previous studies and published literature, with 2/3 of participants reporting pain. There is a tremendous need for ongoing innovations, especially surgical loupes, operating microscopes, and slit-lamp modifications to prevent musculoskeletal disease.

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“…2 Other surgical specialties have been known to experience issues with ergonomics in the operating room for decades. [5][6][7][8] Similarly, poor ergonomics in the office workplace has been well documented to cause a variety of workrelated musculoskeletal disorders (WRMDs). 9,10 While there have been studies done investigating interventions that decrease ergonomic strain in the workplace and other surgical specialties, there is currently little research analyzing how ergonomic risk can be mitigated in the field of otolaryngology.…”

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confidence: 99%

“…Importantly, ergonomic risk is a frequently overlooked and untaught concept leading to unawareness of ergonomic principles, not only in all surgical specialties, but also in other professions 2 . Other surgical specialties have been known to experience issues with ergonomics in the operating room for decades 5‐8 . Similarly, poor ergonomics in the office workplace has been well documented to cause a variety of work‐related musculoskeletal disorders (WRMDs) 9,10 …”

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confidence: 99%

Ergonomics in Otolaryngologic Surgery: A State of the Art Review

Walters

Chang

Cervenka

et al. 2022

Otolaryngol.--head neck surg.

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Objective Otolaryngology is a surgical field with a high degree of ergonomic risk. The use of head-mounted lighting, loupe magnification, endoscopes, and microscopes is inherent to the field, coupled with repetitive fine motor movements in a constrained anatomic field as well as static, ergonomically unfavorable postures. We seek to review the otolaryngologic literature on ergonomics, including prevalence, severity, and interventions in decreasing work-related musculoskeletal pain. Data Sources Data were derived from clinical peer-reviewed primary literature as well as information provided by residency programs and presented at national and international meetings. Review Methods A comprehensive review was performed by 3 independent reviewers utilizing an electronic database literature search through PubMed, Embase, and Cochrane Library. Search terms included combinations and variations of the following concepts: ergonomics, surgery, otolaryngology, work related musculoskeletal disorders, chronic cervical pain, musculoskeletal, posture, surveys, microsurgery, endoscopic surgery. Strict objective criteria for inclusion were not used due to the inherent heterogeneity in articles and lack of rigorous empirical evidence. Conclusions Chronic musculoskeletal pain is prevalent among otolaryngologic surgeons, with many procedures producing high ergonomic risk. Most studies evaluating interventions to decrease ergonomic risks demonstrate promising results, but standardization in methods and outcome reporting is needed. Implications for Practice Literature shows that musculoskeletal pain begins in training, and there is a paucity of information related to ergonomic risk in otolaryngology residency curriculums. Work-related musculoskeletal disorders related to poor workplace ergonomics have the potential to limit career longevity and lead to physician burnout. Interventions to mitigate this risk are effective and tend to be well received by physicians.

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Ergonomics in strabismus surgery

Cited by 4 publications

References 26 publications

Ergonomics of Ophthalmic Surgery: Evaluating the Effect of a Posture Trainer on Trainee Intraoperative Back Posture

Ergonomics of Ophthalmic Surgery: Evaluating the Effect of a Posture Trainer on Trainee Intraoperative Back Posture

The Prevalence of Work-Related Musculoskeletal Disease Among Pediatric Ophthalmologists

Ergonomics in Otolaryngologic Surgery: A State of the Art Review

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