1. Duration
- at least 1 year – lens surgery (basic) or refractive laser surgery (module A)
- at least 2 years – advanced or refractive lens surgery (module AB)
- at least 3 years of refractive and lens surgery (module AD)
2. Training catalogue
- In order to obtain mentor status and to be issued with a fellowship certificate, you must provide evidence of participation in KRC courses recognized by DOG, BVA and DGII in accordance with the following training catalog.
- Evidence of additional courses and wet labs must be provided. (For the trainer, a maximum of the last 5 years, for the fellow, a maximum of the last 3 years)
3. Technical fundamentals of the sub-areas
A), B), C) Lens surgery
- Anatomy of the eye
- Diagnosis and differential diagnosis
- Preoperative diagnostics (biometrics)
- Anaesthetic procedures
- Patient information
- Step-by-step training: paracentesis, tunnel incision, capsulorhexis, IOL implantation, phacoemulsification (central trench, nuclear refraction)
- (Drylab – Simuleye)
- (Cataract Master (AAO) as a simulation program on the Internet)
- Incision geometries
- Phaco machine (Fluidics)
- Capsulorhexis
- Cataract surgery: phacoemulsification and HKL implantation
- Core breaking techniques (D&C, Chop, etc.)
- Difficult initial situations: hard lens (Cat. matura), narrow pupil, shallow anterior chamber, weak zonule fibers
- Complication management: including capsular rupture and anterior vitrectomy, endophthalmitis, Descemet repositioning, suture closure
- IOL implantation sites: capsular bag, sulcus, iris-fixed, scleral-fixed
- IOL exchange
- Sub-area (C) of refractive lens surgery:
Special lenses: RLE, phakic IOL, multifocal IOL, toric IOL, possibly other special lenses (small aperture IOL, light-adjustable IOL) - If necessary, femtosecond laser-assisted cataract surgery (optional)
- Documentation of the above-mentioned interventions
- Emergency service 24/7
D) Refractive surgery
The prerequisite is that the lens surgery module has been completed
- Anatomy of the eye
- Diagnosis and differential diagnosis (including keratoconus detection)
- Preoperative diagnostics including residual stroma determination in re-ops
- Anaesthetic procedures
- Patient information
- Optical basics of refractive corrections
- Physical principles of excimer lasers and femtosecond lasers
- Surface treatments: LASEK, PRK
- Intrastromal treatments: LASIK, Laser Lenticule Extraction (LLE)
- Revision surgery
- Complication management (including anterior vitrectomy limbal, pars plana)
- Documentation of the above-mentioned interventions
- Emergency service 24/7
3.1. Diagnostics to be carried out independently by the Fellow
(under supervision of the mentor)
(in addition to the examinations required by the specialist and documented by written findings)
- Refraction (objective, subjective, cycloplegic)
- Partial coherence interferometry (including IOL master), IOL calculation in difficult initial situations
- Ultrasound (A-/B-scan)
- Corneal topo-/tomography
- Ray tracing calculation, IOL calculation options on the Internet (ASCRS, APSCRS, ESCRS, IOLCon)
- Endothelial cell analysis
- Pachymetry
- Pupillometry (dynamic, static)
- Aberrometry (corneal, intraocular, total)
- Accommodation width measurement
- OCT examination of the macula
3.2. Conservative treatment to be carried out independently by the Fellow
(under supervision of the mentor)
- Reduction of postoperative intraocular pressure increase
- Therapy and acute measures for suspected endophthalmitis
- Postoperative pain therapy
- Keratitis
- more…
3.3. Catalogue of procedures to be performed (1st surgeon)
(under supervision of the mentor)
When applying for the certificate, proof of the procedures performed independently (1st surgeon) as listed below must be submitted.
Catalogue of procedures to be performed (1st surgeon)
| A) Lens surgery (basic) | n = | |
| Lens surgery | Phacoemulsification and HKL implantation | 250 |
| Complication management | Anterior vitrectomy (limbal, pars plana) | 5 |
| Sulcus implantation | 5 |
| B) Lens surgery (Advanced) | n= | |
| Lens surgery | Phacoemulsification and HKL implantation | 300 |
| Difficult starting situations | of that | 50 |
| Narrow pupil (e.g. Malyugin ring, iris retractors) | 10 | |
| Hard or white lens (e.g. trypan blue staining in Cat. matura) | 5 | |
| Weak zonule fibers (capsular tension ring) | ||
| IOL exchange | of that | 20 |
| Explantation from the capsular bag with subsequent refolding, cutting, delivery in toto, followed by implantation of another IOL in the sulcus, capsular bag or iris-fixed) | ||
| Explantation including capsular bag and retroiridal iris fixation of the IOL |
| C) Refractive lens surgery | n= | |
| Refractive Lens Exchange (RLE) | 10 | |
| Toric IOL | 10 | |
| Multifocal IOL | 10 | |
| Phakic IOL | 10 |
| D) Refractive laser surgery | n= | |
| Surface treatments | LASEK/PRK | 50 |
| Interstromal treatments | LASIK** | 50 |
| Laser lenticule extraction* | 50 |
* The professional specialization in the areas of “LASIK” and/or “laser lenticule extraction” can be acquired together or separately, depending on the training center.
4. Requirements for the equipment and organisation of the centre
- Partial coherence interferometry (including IOL Master), possibilities for IOL calculation in difficult initial situations
- Ultrasound (A-/B-scan)
- Corneal topo-/tomography
- Endothelial cell analysis
- Pachymetry
- Pupillometry
- Emergency surgery 24/7
5. Application forms
Lens Surgery and Refractive Surgery Application Form Fellow
Lens Surgery and Refractive Surgery Application Form Mentor
Lens Surgery and Refractive Surgery Application Form Centers