The 45 degree tilt: improvement in surgical ergonomics.

The ergonomics of ocular surgery has received little attention even though the usual positioning of the patient and surgeon during traditional cataract surgery places the surgeon at risk for back, neck, and arm strain. The recent development of the temporal cataract incision allows the operating microscope to be tilted and the patient's head to be turned 45 degrees, permitting the surgeon to assume better posture during ocular procedures. The 45 degree tilt helps the surgeon avoid cervical and lumbar flexion by leaning back in the chair, which produces cervical and lumbar extension and avoids repetitive stress injuries to the neck and lower back.