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Open Access 05-07-2022 | Tremor | Review Article

Overcoming the impact of physiologic tremors in ophthalmology

Authors: Gurfarmaan Singh, Wilson Wong Jun Jie, Michelle Tian Sun, Robert Casson, Dinesh Selva, WengOnn Chan

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 12/2022

Abstract

Purpose

Ophthalmic surgery involves the manipulation of micron-level sized structures such as the internal limiting membrane where tactile sensation is practically absent. All humans have physiologic tremors that are of low amplitude and not discernible to the naked eye; they do not adversely affect the majority of the population’s daily functioning. However, during microsurgery, such tremors can be problematic. In this review, we focus on the impact of physiological tremors on ophthalmic microsurgery and offer a comparative discussion on the impact of such tremors on other surgical specialties.

Methods

A single investigator used the MEDLINE database (via PubMed) to search for and identify articles for inclusion in this systematic review. Ten key factors were identified as potentially having an impact on tremor amplitude: beta-blockers, muscle fatigue, robotic systems, handheld tools/micromanipulators, armrests/wrist supports, caffeine, diet, sleep deprivation, consuming alcohol, and workouts (exercise). These key terms were then searched using the advanced Boolean search tool and operators (i.e., AND, OR) available on PubMed: (*keyword*) AND (surgeon tremor OR microsurgery tremor OR hand steadiness OR simulator score).

Results

Ten studies attempted to quantify the baseline severity of operator physiologic tremor. Approximately 89% of studies accessing the impact of tremors on performance in regards to surgical metrics reported an improvement in performance compared to 57% of studies concluding that tremor elimination was of benefit when considering procedural outcomes.

Conclusions

Robotic technology, new instruments, exoskeletons, technique modifications, and lifestyle factors have all demonstrated the potential to assist in overcoming tremors in ophthalmology.

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Title: Overcoming the impact of physiologic tremors in ophthalmology
Authors: Gurfarmaan Singh
Wilson Wong Jun Jie
Michelle Tian Sun
Robert Casson
Dinesh Selva
WengOnn Chan
Publication date: 05-07-2022
Publisher: Springer Berlin Heidelberg
Keyword: Tremor
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 12/2022
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-022-05718-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Overcoming the impact of physiologic tremors in ophthalmology

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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