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

Abstract

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.

Classification Tree to Analyze Factors Connected with Post Operative Complications of Cataract Surgery in a Teaching Hospital

“…This is a very interesting topic which is much debated [1,40]. However, the role of residents does not appear to be relevant in the onset of this kind of problem, as hypothesized by other studies [37,38]; thus, it is important to emphasize that potentially more complex surgical cases, such as in eyes affected by Pseudo-exfoliation Syndrome or with patients affected by benign prostatic hyperplasia, are not performed by residents in our University.…”

“…Many papers have evaluated the features involved in the intraoperative and postoperative insurgence of complications after this type of surgery [7,10,[36][37][38][39][40][41], but often they have focused on only one or two of them. In contrast, this study has included all the possible complications.…”

“…Both Jacobsen et al [37] and Oliveira-Ferreira et al [38] evaluated the impact of the surgical experience on the rate of complications, observing an association between the procedures performed by residents and the higher number of problems detected after surgery. Their studies provide different results compared to the present one.…”

“…Firstly, AI was used to overcome all the limitations of previously adopted statistical evaluations. Moreover, the first study included only 128 eyes in the overall analysis [37] and the second evaluated only IOP spike 1 day after surgery [38].…”

The Effect of the COVID-19 Pandemic on Cataract and Surgery in Adult Patients: Retrospective Study

“…31,32 Özellikle negatif sonuçlar doğurabilecek ve komplikasyon olma ihtimalini artırabilecek eşlik eden göz patolojileri varlığında daha tecrübeli hekimlerin cerrahi operasyon yapmaları daha uygun bir yaklaşım olacaktır. 33 Bütün bu veriler ışığında kılavuzlarda zaman içerisinde güncellemelerinin yapılmasının faydası olabileceğini düşünmekteyiz. 34 Pandemi döneminin, hekim eğitimi açısından da negatif etkileri bulunmaktadır.…”