How Many Phaco Cases Should a Future Retina Surgeon Perform Before Starting Hands-On Vitreoretinal Training?

Many ophthalmologists planning to be specialized in vitreoretinal surgery ask an important question.

How Much Cataract Surgery Experience is Recommended Before Starting Hands-On Retina Training?

There is no universal number that applies to every surgeon. Progress depends on the quality of training, the level of supervision, and the surgeon’s technical ability. However, most experienced vitreoretinal surgeons agree that a solid foundation in phaco surgery is highly beneficial before beginning hands-on retina procedures.

Why is Phaco Experience Important for Retina Surgeons?

Although retina surgery focuses on the posterior segment, cataract surgery remains closely connected to vitreoretinal practice.

A retina surgeon may encounter:

-            Combined phaco-vitrectomy procedures

-            Cataract associated with retinal disease

-            Cataract progression following vitrectomy

-            Patients requiring cataract surgery before or after retinal intervention

A good understanding of anterior segment surgery helps improve overall surgical planning and patient management.

Is There a Recommended Number of Cases?

There is no official guideline that specifies an exact number of phaco cases before starting retina surgery,

However, many educators recommend that trainees first become comfortable performing routine phaco surgery under supervision before progression to vitreoretinal procedures.

For many surgeons, this level of confidence develops after approximately 5-100 supervised phaco cases, although some may progress sooner while others may require additional experience.

The emphasis should always be on competence rather than simply completing a certain number of cases.

Skills that Retina Trainees Should Develop First

Before starting hands-on retina surgery, ophthalmologists should feel confident with:

-            Microscope control

-            Bimanual coordination

-            Foor pedal control

-            Stable tissue handling

-            Intraocular instrument manipulation

-            Calm decision-making during surgery

These skills developed during phaco training transfer directly to vitreoretinal surgery.

Final Thoughts

Retina surgery is one of the most technically demanding ophthalmic subspecialties. Building a strong foundation in phaco surgery before beginning hands-on vitreoretinal training helps many surgeons develop better microsurgical skills, greater confidence, and improved operating room performance.

Ultimately, the goal is not to reach a specific number of cataract cases, but to acquire the surgical competence and confidence needed to progress safely into retina surgery.