Comparison of Different Types of Complications in the Phacoemulsification Surgery Learning Curve According to Number of Operations Performed

Abstract

Objectives:To compare the differences in intraoperative complications rates by the number of resident-performed sequential phacoemulsification surgeries.Materials and Methods:Preoperative and postoperative ophthalmological examination records and intraoperative data of 180 eyes of 140 patients who underwent cataract surgery by two residents between November 2009 and February 2012 were analyzed retrospectively. The data of 180 eyes were separated into 3 groups based on the number of operations performed: Group A (first 1-60 eyes), group B (61-120 eyes) and group C (last 121-180 eyes). The number of direct supervisor interventions and the rates of different types of complications were compared between the three groups.Results:The number of direct supervisor interventions was 45, 35 and 19 in group A, B and C, respectively. The number of complications anterior to the iris plane was 3, 4 and 12 in group A, B and C, respectively. The difference in the rate of complications between group B and C was statistically significant (p=0.029). The number of complications posterior to the iris plane was 6, 14 and 3 in group A, B and C, respectively. The difference in the rate of complications between the groups was statistically significant (p=0.042, p=0.004).Conclusion:This study provides insight into which types of complications might arise during the phacoemulsification training period. The trends in the rates of different complication types in clinics may be analyzed, and this analysis may be used to improve and modify phacoemulsification training programmes according to the needs of residents.

<p>Assessment of Learning Curve in Phacoemulsification Surgery Among the Eastern Province Ophthalmology Program Residents</p>

“…Residents' performance of phacoemulsification surgery has been evaluated by several studies using various measurement tools. 1,4,5,[9][10][11][12][13][14][15] Most of these studies were retrospective studies that used evaluation of the outcome and complications as a measurement tool, 1,4,5,9,[11][12][13] while few were prospective studies that evaluated intraoperative surgical proficiency level. 10,14,15 To the best of our knowledge, no study has been done to evaluate our training program's residents (the Eastern province ophthalmology training program in Saudi Arabia).…”

“…Both teaching programs and patients' safety entail tracking and measuring the progress of residents' surgical performance. The learning curve can be determined considering several factors including; resident's experience, preoperative risk factors, 4 incidence of complications, 5 case duration, 6 takeover rates, [7][8][9] and proficiency scores for each surgical step. 10 Even though there are several grading systems, none of them has proved to be superior to the other at improving the phacoemulsification learning curve.…”

Comparing Resident Outcomes in Cataract Surgery at Different Levels of Experience: A retrospective case series

“…This nding has also been reported in previous studies. (23,24) In addition, there was a substantial increase in the need for reoperations among S2 patients relative to S1 patients, which re ects the severity of the complications. We attribute this nding to a possible feeling of overcon dence demonstrated by residents after their completion of the rst semester of initial training without many intraoperative events.…”

Harmonizing cataract surgery training and patient‐centred care in 2020: Disclosure, consent, supervision and patient altruism

“…Unquestionably, a key component in the training of ophthalmic surgeons is surgical experience; the learning curve for phacoemulsification surgery has been shown to follow an exponential pattern with major reductions in complication rates throughout phases of training. [1][2][3][4] Nonetheless, even with stratification of risk, complication rates typically remain a little higher for trainees than consultant ophthalmologists in public teaching hospitals. 5,6 Therefore, in the era of patient-centred care (PCC), that is, "Providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions," 7 disclosure of trainee involvement during informed consent may impact core aims of teaching hospitals to train surgeons.…”