Abstract: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 in… Show more
“…However, surgeons who are starting to adopt chandelier scleral buckling techniques are likely to require more time and may not find operative times in chandelier scleral buckling to be shorter than in standard scleral buckling. 51 Future studies with a larger sample could further explore differences in operative times between standard scleral buckling and chandelier scleral buckling to better determine whether there is a significant difference.…”
Purpose: To examine the outcomes of chandelier endoillumination–assisted scleral buckling (chandelier scleral buckling) for rhegmatogenous retinal detachments (RRDs) and compare them with those of standard scleral buckling using indirect ophthalmoscopy. Methods: A literature search was performed on April 15, 2023. Outcomes analyzed included primary anatomic success rates, surgical duration, and complication rates. A meta-analysis of proportions estimated the pooled success rate of chandelier scleral buckling. In addition, meta-analyses compared the success rates between pseudophakic eyes and phakic eyes having chandelier scleral buckling and compared success rates and surgical duration between standard scleral buckling and chandelier scleral buckling. Results: Thirty studies with 1133 eyes were included. The pooled primary anatomic success rate of chandelier scleral buckling was 91.7% (95% CI, 89.6%-93.6%). In studies comparing success rates between the 2 techniques, there was no significant difference (risk ratio, 1.01; 95% CI, 0.94-1.08; P = .80). The surgical times were significantly shorter with chandelier scleral buckling than with standard scleral buckling (mean difference, −18.83; 95% CI, −30.88 to −6.79; P = .002). There was no significant difference in the success rate between pseudophakic eyes and phakic eyes (risk ratio, 0.99; 95% CI, 0.91-1.08; P = .89). No cases of endophthalmitis were reported. Conclusions: Chandelier endoillumination–assisted scleral buckling may be a promising technique given its high rate of primary anatomic success for RRDs and success rates similar to those of standard scleral buckling. There was no significant difference in the efficacy of chandelier scleral buckling between pseudophakic eyes and phakic eyes
“…However, surgeons who are starting to adopt chandelier scleral buckling techniques are likely to require more time and may not find operative times in chandelier scleral buckling to be shorter than in standard scleral buckling. 51 Future studies with a larger sample could further explore differences in operative times between standard scleral buckling and chandelier scleral buckling to better determine whether there is a significant difference.…”
Purpose: To examine the outcomes of chandelier endoillumination–assisted scleral buckling (chandelier scleral buckling) for rhegmatogenous retinal detachments (RRDs) and compare them with those of standard scleral buckling using indirect ophthalmoscopy. Methods: A literature search was performed on April 15, 2023. Outcomes analyzed included primary anatomic success rates, surgical duration, and complication rates. A meta-analysis of proportions estimated the pooled success rate of chandelier scleral buckling. In addition, meta-analyses compared the success rates between pseudophakic eyes and phakic eyes having chandelier scleral buckling and compared success rates and surgical duration between standard scleral buckling and chandelier scleral buckling. Results: Thirty studies with 1133 eyes were included. The pooled primary anatomic success rate of chandelier scleral buckling was 91.7% (95% CI, 89.6%-93.6%). In studies comparing success rates between the 2 techniques, there was no significant difference (risk ratio, 1.01; 95% CI, 0.94-1.08; P = .80). The surgical times were significantly shorter with chandelier scleral buckling than with standard scleral buckling (mean difference, −18.83; 95% CI, −30.88 to −6.79; P = .002). There was no significant difference in the success rate between pseudophakic eyes and phakic eyes (risk ratio, 0.99; 95% CI, 0.91-1.08; P = .89). No cases of endophthalmitis were reported. Conclusions: Chandelier endoillumination–assisted scleral buckling may be a promising technique given its high rate of primary anatomic success for RRDs and success rates similar to those of standard scleral buckling. There was no significant difference in the efficacy of chandelier scleral buckling between pseudophakic eyes and phakic eyes
“…Given the higher complication rates seen in resident training, this tip may have the potential to create a safer surgery for patients. 19–21 Furthermore, given the improved safety profile and equivalent efficiency, it could improve the performance of beginning and advanced surgeons in the future. The technology used in phacoemulsification has room to improve, and this new hybrid tip has the potential to improve cataract surgery safety without a loss in efficiency.
WHAT WAS KNOWN
The hybrid tip has been shown to decrease the incidence of PCR in a laboratory setting.To the authors' knowledge, the impact of the hybrid tip on phacoemulsification efficiency has not been studied.
WHAT THIS PAPER ADDS
The hybrid tip does not demonstrate a significant loss in efficiency, making it a useful option given its improved safety profile.This tip can be considered for trainee surgery to improve patient safety and training experience.Use of the tip by experienced surgeons may also provide benefit to patient safety without affecting efficiency.…”
Section: Discussionmentioning
confidence: 99%
“…3 Given the higher complication rates seen in resident training, this tip may have the potential to create a safer surgery for patients. [19][20][21] Furthermore, given the improved safety profile and equivalent efficiency, it could improve the performance of beginning and advanced surgeons in the future. The technology used in phacoemulsification has room to improve, and this new hybrid tip has the potential to improve cataract surgery safety without a loss in efficiency.…”
To determine whether there is a difference in efficiency during phacoemulsification when using the hybrid polymer tip compared with the metal balanced tip, as measured by cumulative dissipated energy (CDE) and total procedure time.
“…According to previous results, phacoemulsification and capsulorhexis are the highest demanding steps in cataract surgery for residents [20,45]. The number of intra-and postoperative complications was described to be steadily decreasing with increasing number of previous procedures [34,[46][47][48]. However, Al-Jindan et al reported that after 40 procedures, proficiency levels were fairly satisfying [20].…”
Purpose
To assess the rate of pseudophakic cystoid macular edema (pCME) in uneventful cataract surgery in surgeons in training vs experienced surgeons and to analyze the rate of pCME according to surgeon’s sex.
Methods
Medical reports post phacoemulsification between 2010 and 2018 at the Department of Ophthalmology, Medical University of Graz, Austria, were reviewed for pCME. A running lifetime number of preceding cataract surgeries was used to express hands-on experience. A cut-off number of 300 surgeries was defined to distinguish between surgeons in training and experienced surgeons. Outcome parameters were incidence of pCME, patient’s sex and age, laterality of eye, coexistence of pseudoexfoliation syndrome (PEX), duration of surgery and surgeon’s sex.
Results
25.422 surgeries on 18.266 patients were included. The majority was performed by experienced surgeons (23.139, 91.0%) vs 2.283 (9.0%) by surgeons in training (25 surgeons, 9 (36%) female and 16 (64%) male). pCME occurred in 32 eyes (1.4%) following surgery by surgeons in training and in 152 eyes (0.7%) following surgery by experienced surgeons. Chance for pCME was 1.57 higher in training surgeries (95% CI 1.03–2.41, p = 0.034) and longer duration (OR = 1.04; 95% CI 1.02–1.07, p = 0.001). After excluding the first 100 surgeries for every surgeon in training similar results were observed. No difference in risk for pCME was found between female and male surgeons in both groups (training and experienced surgeons).
Conclusion
In conclusion, the rate for pCME after uneventful cataract surgery is significantly higher for surgeons in training but steadily decreasing and associated to surgical time. No difference in the risk for pCME was found between female and male surgeons.
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