Complication rates of resident-performed cataract surgery: Impact of early introduction of cataract surgery training

Ellis, Erika; Lee, Jeffrey E.; Saunders, Luke J.; Haw, Weldon W; Granet, David B.; Heichel, Christopher W.D.

doi:10.1016/j.jcrs.2018.06.022

Cited by 20 publications

(25 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This early introduction has also been shown to decrease intraoperative complication rates significantly. 41 The use of various surgical simulators has shown promising results in hastening residents' learning curve in phacoemulsification. [42][43][44] In the UK database study of 17,831 cataract surgeries done by first and second-year residents, there was a 38% reduction in posterior capsular rent (4.2% in 2009 vs 2.6% in 2015) for surgeons with access to an EyeSi simulator.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

<p>Operative Time and Complication Rates of Resident Phacoemulsification Surgeries in a National University Hospital: A Five-Year Review</p>

Umali¹,

Castillo²

2020

OPTH

View full text Add to dashboard Cite

Purpose: To determine the operative time and complication rates of resident phacoemulsification surgeries at different time points in training. Methods: Retrospective cross-sectional study at the Department of Ophthalmology of the Philippine General Hospital. All resident-performed elective adult phacoemulsification surgeries from January 1, 2014, to December 31, 2018, were included, while operations with planned anterior or posterior procedures were excluded. Cases were arranged chronologically and divided into time points with 25 cases each. Operative time and complication rates were computed for each time point. As defined by the ICO Ophthalmology Surgical Competency Assessment Rubric (OSCAR), 30 minutes was used to gauge competency based on operative time, while complications were compared to published rates for residents. Results for the first 50 cases, the minimum number required by graduation, were also compared with succeeding cases. Results: A total of 4635 cases were included. Residents performed an average of 115.9 ± 30.4 cases, with no significant difference among residents (F(4,35)=2.64, p=0.12). Overall complication rate was 6% (n=276), similar to those reported internationally. Both median operative time and complication rates decreased significantly for every time point in training (p<0.001). After 50 cases, only 40% (n=16) of residents reached the operative time of 30 minutes. Median operative time is significantly lower when comparing the first 50 surgeries with the succeeding cases (37 minutes vs 29 minutes, p<0.001). Likewise, complication rate is also significantly lower (9.3% vs 3.5%, Χ 2 (1, N=4635) = 68.481, p<0.001), with an odds ratio of 2.85 (p<0.001, 95% CI [2.2, 3.7]). Conclusion: There are significant improvements in both operative time and complication rates as more surgeries are performed. However, the minimum required 50 cases is not enough for resident competency based on operative time and complication rates.

show abstract

Section: Discussionmentioning

confidence: 99%

“…This early introduction has also been shown to decrease intraoperative complication rates significantly. 41 …”

Section: Discussionmentioning

confidence: 99%

<p>Operative Time and Complication Rates of Resident Phacoemulsification Surgeries in a National University Hospital: A Five-Year Review</p>

Umali¹,

Castillo²

2020

OPTH

View full text Add to dashboard Cite

show abstract

“…Moreover, there was no difference in overall complication rates between resident and staff surgeons in their study, although it is not clear how patient selection was conducted. Low PCR rates, under 2%, were also reported by other authors (15,34,35); however, in some studies such low rates were achieved only in the final phase of training and not presented as an overall complication rate through the whole training period (35).…”

Section: Discussionmentioning

confidence: 50%

“…Furthermore, PXF and the use of α1-blockers were associated with reduced post-operative visual acuity (13). To reduce the rate of complications, such as PCR and vitreous loss, the installation of surgical curriculum in the residency program was suggested (14,15). Posterior capsule rupture, in turn, was associated with 42-fold risk for retinal detachement and 8-fold risk for endophthalmitis within 3 months after cataract surgery (16).…”

Section: Introductionmentioning

confidence: 99%

Cataract complications study: an analysis of adverse effects among 14,520 eyes in relation to surgical experience

Aaronson¹,

Kanclerz²,

Grzybowski³

et al. 2020

Ann Transl Med

View full text Add to dashboard Cite

show abstract

“…Consequentially, our rate of intraoperative complications is higher than other studies investigating the more classical definition of intraoperative complications (Quillen & Phipps 2003; Ellis et al. 2018). However, if we follow similar definitions the occurrence of intraoperative complications is similar to other studies investigating resident performed cataract surgery (Quillen & Phipps 2003; Ellis et al.…”

Section: Discussionmentioning

confidence: 53%

Defining the surgical footprint in cataract surgery: patient‐related outcomes dependent on the experience of the surgeon

Jacobsen

Holm

Erichsen

et al. 2020

Acta Ophthalmologica

View full text Add to dashboard Cite

Purpose To investigate which patient‐related outcomes are dependent on the experience of the cataract surgeon. Methods The study was designed as a prospective observational study. Novice (<150 surgeries performed) and experienced (>1000 surgeries performed) cataract surgeons from the Department of Ophthalmology, Rigshospitalet – Glostrup and Nordsjællands Hospital – Hillerød were included in the study. Patients operated by the included surgeons were examined preoperatively, 1 day, 3 days, and 3 weeks after standard, noncomplicated cataract surgery. Primary outcomes were change in central corneal thickness and endothelial cell loss. Secondary outcomes were best‐corrected visual acuity, intraocular pressure, aqueous flare, central macular thickness, and surgical complications. Results Surgery performed by novice surgeons resulted in significantly lower visual acuity (mean −3.6 letters (Early Treatment Diabetic Retinopathy Study (ETDRS)); 95% CI: −7.3; −0.4, p = 0.03) and greater corneal thickness (mean 26.7 µm; 95% CI: 6.8; 46.6, p = 0.01) on the first day postoperative than surgery performed by experienced surgeons. Conclusion The experience of the cataract surgeon affected visual acuity and central corneal thickness in the immediate postoperative period. In the future, these patient‐related outcomes may be used to assess the technical proficiency of surgical trainees and investigate the effect of different training programs.

show abstract

Complication rates of resident-performed cataract surgery: Impact of early introduction of cataract surgery training

Abstract: Early introduction of cataract surgery training significantly decreased the rate of major intraoperative complications, specifically anterior vitrectomy, in resident-performed cataract surgeries.

Cited by 20 publications

References 28 publications

<p>Operative Time and Complication Rates of Resident Phacoemulsification Surgeries in a National University Hospital: A Five-Year Review</p>

<p>Operative Time and Complication Rates of Resident Phacoemulsification Surgeries in a National University Hospital: A Five-Year Review</p>

Cataract complications study: an analysis of adverse effects among 14,520 eyes in relation to surgical experience

Defining the surgical footprint in cataract surgery: patient‐related outcomes dependent on the experience of the surgeon

Contact Info

Product

Resources

About