Prayer of the Cataract Surgeon
I wrote this during my training in ophthalmology, and I hope it helps upcoming residents and fellows relieve some of their stress.
Dear God,
Thank you very much for keeping all of the posterior capsules intact yesterday… I thank you for everything…
I am praying more for my patients than merely for myself…
Please let my cataract patients live the rest of their lives with intact posterior capsules… Sometimes, as you know, mishaps happen… I don't do it intentionally, but it just happens… In that way, I am innocent… but I am also guilty…
I do manage it in the best possible way, with minimum effect on their post-operative vision, but still, sometimes I feel I have not given them the best possible… They are not abnormal as far as their vision is concerned, but they are not normal either…
God, I do have a few questions for you…
God, why did you give nuclear sclerosis to the most beautifully transparent tissue of our body, the crystalline lens? Now you will say I am asking this even though it is your business… God, I know that you have planned everything in the most perfect sense for human beings… I suppose the reason behind nuclear sclerosis might be the need for near vision in elderly people… but didn't you realise that it would take away our distance vision? And as the most intelligent species on earth, we don't compromise… so we created us, the eye surgeons…
God, I think I got the reason behind nuclear sclerosis… but then, why did you keep the posterior capsule just 4 microns thick and the anterior capsule 10 microns? Don't you think it should have been the other way around? It might have helped us a lot, dear God…
God, you might have seen all this coming… As we have increased our lifespan, we have had to find different ways to improve our vision… We started with couching, and we will not end with femto-cataract surgery… We will keep chasing your natural crystalline lens till the end of the world… and we know that even you wish the same…
God, I do want you to know that I love this brilliant structure, the crystalline lens, even more than a real diamond… Yes, it gleams more than a diamond… and sometimes, when you leave those designs in it… I just love that…
I am ending with this for today… Thank you, God… Help me save all the posterior capsules today…
Why This Prayer Still Resonates
Almost every cataract surgeon carries a quiet fear of the posterior capsule giving way. This prayer names that fear honestly: gratitude for the cases that went well, the uncomfortable mix of innocence and guilt when one does not, and a sense of wonder at the crystalline lens itself. If you are a resident who has felt this, you are in good company.
For Residents: After a Difficult Case
- Your patient comes first. Manage the complication calmly, follow the patient closely, and explain honestly what happened and what it means for their vision.
- Watch the video with a mentor. Reviewing the recording with someone experienced turns a bad day into a lesson.
- Talk about it. Discussing cases openly in departmental meetings helps everyone, including the surgeons who are too shy to ask.
- Remember it is part of the learning curve. Complications happen to every surgeon who operates; one case does not define you.
- Look after yourself. Sleep, eat, and speak to a colleague or friend. A rested surgeon is a safer surgeon.
For the practical steps, see the Posterior Capsular Tear Management Flowchart and Phaco Tips & Tricks.
A Few Lines to Carry Into Theatre
- Respect the capsule.
- When in doubt, stop, stabilise, and think.
- We just remove cataracts; God gives vision.
Planning cataract surgery? Learn about cataract surgery at Sadbhaav or book a consultation with Dr. Dhaval Patel.