Results of pars plana vitrectomy after complicated phacoemulsification surgery

Grandinetti, Alexandre Achille; Suenaga, Diogo; Oliveira, Fernanda Midori de; Cruz, Krissis Saliba Uliana; Meneguette, Laurinda; Moreira, Luciane Bugmann

doi:10.5935/0004-2749.20150020

Cited by 3 publications

(1 citation statement)

References 18 publications

(24 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These factors have detrimental consequences for surgical training, with reduced registrar exposure and confidence levels in performing more complex cataract surgery [ 20 ]. While it has been suggested that immediate management by vitreoretinal specialists optimises outcomes in cases complicated by PCR [ 21 ], this is both impractical from a logistical perspective and fails to take into account that not all ophthalmology departments have an on-site vitreoretinal service. Jamison et al assessed the real-term costs of PCR to NHS ophthalmology departments (in terms of additional surgical equipment utilised and outpatient visits) and estimated this to be between £1178.20 and £2124.67 [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Confidence of UK Ophthalmology Registrars in Managing Posterior Capsular Rupture: Results from a National Trainee Survey

et al. 2021

View full text Add to dashboard Cite

Introduction To establish the level of confidence amongst UK ophthalmology specialist registrars (residents) in managing posterior capsule rupture (PCR) during cataract surgery. Methods An online nine-item questionnaire was distributed to all registrars, recruited nationwide via regional representatives. Data collected included stage of training, number of completed cataract operations, cumulative PCR rate, number of PCRs independently managed, understanding of vitrectomy settings and fluidic parameters and access to simulation. Respondents self-evaluated their confidence in managing PCR with vitreous loss. Results Complete responses were obtained from 248 registrars (35% response rate). Mean number of phacoemulsification procedures performed was 386. For senior registrars (OST 6–7), 35 out of 70 (50%) felt confident to manage PCR independently and 55 out of 70 (78.6%) were either quite confident or very confident at deciding when to implant an intraocular lens during PCR management. Lower confidence levels were noted for junior trainees (OST 1–2). Over 65% of survey respondents had access to relevant simulation. Conclusions Our results represent the largest UK survey analysing the confidence of PCR management amongst registrars. Confidence improves with duration of training and increased exposure to management of PCR. However, 50% of senior registrars still lacked confidence to independently manage PCR and vitreous loss. A specific competency-based framework, potentially using a simulator or simulating a PCR event, incorporated into the curriculum may be desirable.

show abstract

Section: Discussionmentioning

confidence: 99%

Confidence of UK Ophthalmology Registrars in Managing Posterior Capsular Rupture: Results from a National Trainee Survey

et al. 2021

View full text Add to dashboard Cite

show abstract

Kapselruptur und Vitrektomie bei Phakoemulsifikation

Kohnen

Lotfipour

2018

Ophthalmologe

View full text Add to dashboard Cite

show abstract

Confidence of ophthalmology specialist trainees in the management of posterior capsule rupture and vitreous loss

Turnbull

Lash

2016

Eye

View full text Add to dashboard Cite

Purpose To ascertain ophthalmology trainee confidence in managing posterior capsule rupture (PCR) and vitreous loss. Methods An electronic survey was distributed to ophthalmology trainees in a single UK postgraduate training Deanery. Data collected included the stage of training, number of completed cataract operations, cumulative PCR rate, number of PCRs personally managed by the trainee, previous vitrectomy experience during vitreoretinal rotations, and attendance at advanced phacoemulsification courses. Trainees self-evaluated their confidence in managing PCR with vitreous loss, including the management of specific aspects of the procedure. Results Across training grades, only 9.1% (2/22) felt confident managing PCR without senior support. Respondents were most confident with fluidic parameters and IOL considerations, but 77.3% (17/22) lacked confidence in avoiding a dropped nucleus. Eleven respondents had completed 4350 cases (mean 576; range 383-1087). In this subgroup, mean cumulative PCR rate was 2.1% (range 0.9-4.9%), and trainees personally managed a mean 3.5 cases of PCR (range 1-7). Only 18.2% felt they could manage PCR and vitreous loss without senior support, and 45.5% stated they were not confident in avoiding a dropped nucleus. The most experienced trainee (1087 cases) had personally managed PCR just six times, and three trainees with 4350 cases had only managed PCR once each. Conclusions The Royal College of Ophthalmologists' requirement of 350 completed cases appears insufficient for independent cataract surgery, as opportunities to manage complications as a trainee are scarce. A competency-based assessment framework may be preferable, with a more targeted approach to training incorporating surgical simulation within the formal curriculum.

show abstract

Results of pars plana vitrectomy after complicated phacoemulsification surgery

Cited by 3 publications

References 18 publications

Confidence of UK Ophthalmology Registrars in Managing Posterior Capsular Rupture: Results from a National Trainee Survey

Confidence of UK Ophthalmology Registrars in Managing Posterior Capsular Rupture: Results from a National Trainee Survey

Kapselruptur und Vitrektomie bei Phakoemulsifikation

Confidence of ophthalmology specialist trainees in the management of posterior capsule rupture and vitreous loss

Contact Info

Product

Resources

About