Complication rate and risk factors for intraoperative complications in resident-performed phacoemulsification surgery

Briszi, Andrea; Prahs, Philipp; Hillenkamp, Jost; Helbig, Horst; Herrmann, Wolfgang A.

doi:10.1007/s00417-012-2003-y

Cited by 62 publications

(46 citation statements)

References 26 publications

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“…In our study, the overall intraoperative complication rate (15.12%) was in the upper normal range reported elsewhere (1.8 % to 15%) [5][6][7][8][9][10][11][12] . Th is could be explained by the fact that half of the trainees (4/8) were at the very beginning of the operating learning curve, having only wet lab experience.…”

Section: %supporting

confidence: 64%

“…Unfortunately, even though ophthalmology residents in foreign countries spend a large proportion of their surgical training learning cataract surgery 3 , in our country it was not common practice 4 . As many previous studies showed that complication rates and outcomes of cataract surgery performed by residents were acceptable [5][6][7][8][9][10][11][12] , it was decided to start fi rst resident phacoemulsifi cation-learning program at the Clinical Department of Ophthalmology, Sestre milosrdnice University Hospital Center. Th e purpose of this pilot study was to analyze the resident learning process of phacoemulsifi cation cataract surgery at the Clinical Department of Ophthalmology, Sestre milosrdnice University Hospital Center, and to assess the resident phacoemulsifi cation learning curve in order to implement cataract surgery training into the residency program in the future.…”

Section: Introductionmentioning

confidence: 99%

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The Resident Surgeon Phacoemulsification Learning Curve at Clinical Department of Ophthalmology, Sestre Milosrdnice University Hospital Center

Lončar

Tadić

Dujmović

et al. 2016

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SUMMARY -Th e aim of the study was to analyze the resident learning process of phacoemulsifi cation cataract surgery and to assess the resident phacoemulsifi cation learning curve. Th is prospective study comprised 86 consecutive cases of phacoemulsifi cation performed using standard technique by eight residents over a one-year period at Clinical Department of Ophthalmology, Sestre milosrdnice University Hospital Center in Zagreb. Operative data on each case included resident and attending surgeon, date of operation, step-by-step success questionnaire, and intraoperative complications. Postoperative data included visual acuity at one-month postoperative visit and postoperative complications. Eighty-six operations were performed under the supervision of attending surgeon. Th e mean best-corrected visual acuity improved from 0.47±0.25 to 0.8±0.25 postoperatively. Intraoperative complications occurred in 13 (15.12%) cases and continued to decrease throughout residency training. Th e mean number of individually performed steps per operation increased throughout residency (from 7.6 to 9.0). Th ere was one early postoperative complication, endophthalmitis, which was successfully treated, and no other postoperative complications occurred. Resident surgical competency can be improved by maximizing the number of cataract procedures since the complication rates and the number of individually performed steps improved continuously with increasing surgical experience.

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Section: %supporting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

The Resident Surgeon Phacoemulsification Learning Curve at Clinical Department of Ophthalmology, Sestre Milosrdnice University Hospital Center

Lončar

Tadić

Dujmović

et al. 2016

acc

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“…We found that the rate of hospitalization after surgery was significantly higher when operations were performed by residents, perhaps due to a higher prevalence of more severe complications. Although it has been shown that the quality of operations by residents, especially phacoemulsification surgery, is acceptable (29,30), complications such as vitreous loss (31)(32)(33) are more common; therefore, all patients should undergo a complete evaluation before surgery to prevent or reduce the incidence of complications (34,35).…”

Section: Discussionmentioning

confidence: 99%

Trends in outpatient cataract surgery in the Islamic Republic of Iran, 2006-2010

Hashemi

Fotouhi

Rezvan

et al. 2016

East Mediterr Health J

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This study aimed to determine the trends in outpatient cataract surgery and its determinants in the Islamic Republic of Iran between 2006 and 2010. In this cross-sectional study, 106 cataract surgery centres were selected in all provinces by multistage randomized cluster sampling. The number of centres in each province was determined from the number of cataract operations and the number of patient charts examined in each centre was proportionate to the number of cataract operations in that centre. The prevalence of outpatient surgery increased from 46.0% (95% CI, 35.3-56.8) in 2006 to 51.4% (95% CI, 40.2-62.7) in 2010 (P = 0.549). Patients stayed in hospital for more than one night after 10.5% (95% CI, 6.9-14.1) of operations. Use of phacoemulsification and topical anaesthesia increased the prevalence of outpatient surgery and decreased intraoperative complications. Although outpatient cataract surgery increased by 11.7%, use of methods such as phacoemulsification is not widespread, and more attention should be paid to the barriers to outpatient cataract surgery in the Islamic Republic of Iran. . Les patients sont restés plus d'une nuit à l'hôpital après 10,5 % (IC à 95 %, 6,9-14,1) des opérations. Le recours à la phaco-émulsification et l'anesthésie topique faisait augmenter la prévalence de la chirurgie ambulatoire et réduisait les complications intra-opératoires. Bien que la chirurgie de la cataracte en ambulatoire ait augmenté de 11,7 %, l'utilisation de méthodes telles que la phaco-émusification n'est pas répandue, et davantage d'attention devrait être apportée aux obstacles qui s'opposent à la chirurgie de la cataracte en ambulatoire en République islamique d'Iran. 2010-‫املتوسط‬ ‫لرشق‬ ‫الصحية‬ ‫املجلة‬ ‫العرشون‬ ‫و‬ ‫الثاين‬ ‫املجلد‬ ‫التاسع‬ ‫العدد‬ 677

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“…[13] Several other studies showed lower complication rates in residents training programs varying from 3% to 7%. [9][10][11][12][13][14][15][16] …”

Section: P Valuementioning

confidence: 99%

“…Other experienced tutors let residents try the whole procedure all at once. So far a number of teaching techniques have been described [9,10] ; however, to the best of our knowledge there are no published studies in the literature directly comparing their efficacy on resident surgical outcomes.…”

Section: Introductionmentioning

confidence: 99%

Surgical Challenges Faced by Trainee Surgeons- A Prospective Comparative Study

Mushriff¹,

Telgote²,

Patel³

2017

jemds

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BACKGROUNDHuman resources like Doctors form the important part of all health systems. To achieve health objectives and goals, health resources should be distributed evenly among people irrespective of economic, social and geographical barriers. The aim of this study is to evaluate the surgical challenges faced by trainee Ophthalmologists and to compare the efficacy of two different methods of training; step-by-step method and one-step method are the two ways of training practiced to train ophthalmologists. This study compares the two ways of training by evaluating complications at the end of surgeries performed by trainee surgeons. Setting-Department of Ophthalmology, Index Medical College and Research Centre. Study Design-A Prospective Comparative Study. MATERIALS AND METHODSTime Period-1 st January 2017 to 31 st March 2017, 3 months. Cataract Surgery performed-Manual Small Incision Cataract Surgery performed within the above-mentioned period (80 SICS). Study was divided into 2 Groups accordinglyGroup 1-Including residents that were trained with the 'step-by-step' method (44 SICS). Group 2-Including residents that were trained with the 'one-step' method (36 SICS).1. Residents were evaluated for the ease of performing surgical steps. 2. Complications were recorded in terms of premature entry, buttonholing, running away of capsulorhexis, rhexis tear, zonular dialysis/dehiscence, posterior capsular rent/rupture, iridodialysis, vitreous loss. Both of the above-mentioned groups were compared according to various difficulties encountered in each approach and their management was done by the supervising surgeon. Patient was followed for 1 month. Data were listed and counted with Excel (Version 2007, Microsoft). Mean and Standard deviation was calculated. Chi-square and Student t-tests were used to assess statistical significance between groups. RESULTS 44 surgeries were done in "step-by-step" group of which 18 patients were male and 26 were female; and 36 surgeries were done in "one-step" group of which 20 were male and 16 were female. Mean age group of patient in "step-by-step" group was 64.22 ± 10.10 years and 63.50 ± 8.46 years in "one-step" group. Overall complication rate when compared between 2 groups were more in "onestep" group, which was significant in contrast to when individual complication rates were compared between two groups. CONCLUSIONThus to conclude, learning surgery is always an uphill task for a trainee. A great degree of temperament, practice and skills are required before proficiency is achieved. In our study, 2 approaches were practiced in learning SICS-"step-by-step" and "one-step"; and "step-by-step" approach was found beneficial for the beginners. KEYWORDS SICS, Trainee Surgeon, Cataract, Post-Operative Complication. HOW TO CITE THIS ARTICLE:Mushriff S, Telgote V, Patel K. Surgical challenges faced by trainee surgeons-a prospective comparative study.

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Complication rate and risk factors for intraoperative complications in resident-performed phacoemulsification surgery

Abstract: Residents achieve an acceptable complication rate during their initial 100 phacoemulsification cases.

Cited by 62 publications

References 26 publications

The Resident Surgeon Phacoemulsification Learning Curve at Clinical Department of Ophthalmology, Sestre Milosrdnice University Hospital Center

The Resident Surgeon Phacoemulsification Learning Curve at Clinical Department of Ophthalmology, Sestre Milosrdnice University Hospital Center

Trends in outpatient cataract surgery in the Islamic Republic of Iran, 2006-2010

Surgical Challenges Faced by Trainee Surgeons- A Prospective Comparative Study

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