Resident Physician Operative Times During Cataract Surgery

Wiggins, Michael N; Warner, David

doi:10.3928/15428877-20100726-07

Cited by 28 publications

(24 citation statements)

References 5 publications

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“…13 When reported, the duration of surgery ranged from an average of 30 min in studies published in 2003 to 15–19 min in recent reports 14–17. Our objective measure of procedures lasting 13 min is in line with this shortening that most probably stems from improvements in the technique of cataract surgery, including suture-less clear corneal microincisions.…”

Section: Discussionmentioning

confidence: 99%

Patients’ subjective assessment of the duration of cataract surgery: a case series

et al. 2013

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ObjectivesSurgery duration is a source of preoperative anxiety for patients undergoing cataract surgery. To better inform patients, we evaluated the agreement between objective and patient-perceived surgery durations.DesignCase series.SettingPublic teaching university hospital (Paris, France).ParticipantsDuring the study period, 368 cataract surgery cases performed on 285 patients were included, 85 cases were excluded from the final analysis. All patients who had uneventful phacoemulsification were included. Cases with any significant intraoperative adverse event or cases requiring additional anaesthesia other than topical were excluded. Resident performed cases were also excluded.Primary and secondary outcomesProcedures were timed (objective duration) and patients were asked, immediately afterwards, to assess the duration of their surgery (patient-assessed duration). The agreement between objective and patient-assessed durations as well as influencing factors was studied.ResultsMean objective duration (13.9±5 min) and patient-assessed duration (15.3±6.9 min) were significantly correlated (Spearman's r=0.452, p<0.0001). Furthermore, Bland-Altman analysis and the intraclass correlation coefficient (0.341, 95% CI 0.23 to 0.44) were quite in agreement. On univariate analysis, senior-performed procedures were significantly shorter than those performed by juniors (13.4 vs 17.8 min, p=0.0001). Pain was recorded as ‘no sensation’ (31.5% of the cases), ‘mild sensation’ (41%), ‘moderate pain’ (23.3%), ‘intense pain’ (3.5%) and ‘unbearable pain’ (0.7%). Groups with high pain score had significantly longer procedures (p<0.001). Multivariate analysis revealed that the only independent factors associated with both the objective and patient-assessed durations of surgery were surgeon's experience and pain-score.ConclusionsIn our study, patients’ estimated and real duration of the surgery showed moderate agreement, suggesting that emotions associated with eye surgery under topical anaesthesia did not dramatically hinder the patients’ perception of time. However, the benefit of preoperative counselling regarding the duration of surgery will need further evaluation.

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Section: Discussionmentioning

confidence: 99%

Patients’ subjective assessment of the duration of cataract surgery: a case series

et al. 2013

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“…Because the average operation time was shorter, this difference would mean three rather than four cases per list. Complex procedures were often allocated to consultants and this created an acknowledged length time bias 11,16,18,22–24,34 …”

Section: Resultsmentioning

confidence: 99%

“…In the retrospective studies, [10][11][12][13][14][15][16][17][18][19][20][21][22] the average difference in 'incision to last suture' time between the consultant and supervised trainee was 28 min (range 7-60). The additional training time would mean two rather than three cases per 4-h list.…”

Section: Resultsmentioning

confidence: 99%

Lost opportunity cost of surgical training in the Australian private sector

Aitken

2012

ANZ Journal of Surgery

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“…The adaptation of core competencies 7 , structured surgical curriculums 8 , microsurgical labs 9 and surgical simulation devices 10–13 are all currently utilized to varying degrees to help solidify basic surgical techniques. 14 However, previous surveys have also identified advanced cataract techniques and corneal refractive surgery as areas of perceived underexposure in residency 15, 16 (possibly also Lee/Koch- don’t know, waiting on article ).…”

mentioning

confidence: 99%

Resident surgical experience with lens and corneal refractive surgery: Survey of the ASCRS Young Physicians and Residents Membership

Yeu¹,

Reeves²,

Wang³

et al. 2013

Journal of Cataract and Refractive Surgery

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Purpose To evaluate the quantity and perceived quality of Ophthalmology resident surgical experience with surgical astigmatism management, new technology IOL implantation, and corneal refractive surgery. Setting US ACGME Ophthalmology Residency current members and recent graduates via electronic survey. Methods A 43-question survey was emailed to all resident members of ASCRS, ASCRS members in practice for 5 years or less, and to residency program directors of 118 U.S. ACGME accredited ophthalmology programs in June 2010. The surveys were performed electronically using Survey Monkey, a commercially available Internet-based survey web service. Results Two hundred and seventy-six surveys were included. Most of the respondents (88.7%) served as primary surgeon in over 100 cataract surgeries, and 89.4% of respondents felt their exposure to cataract surgery was either “adequate” or “excessive”. Fifty-two percent of respondents had not performed corneal relaxing incisions and 60% of respondents had no experience implanting a toric IOL. Twenty-two percent of respondents had experience implanting a presbyopia-correcting IOL, while most (??%) felt that this training should begin in residency. Over 75% of respondents had not performed LASIK or surface ablation procedures; while most (80.9%) felt that this training should begin in residency. Conclusions While total cataract case numbers appear adequate, there are significant perceived deficiencies in current resident training models in preparing future surgeons for procedures and techniques they are likely to utilize after residency.

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Resident Physician Operative Times During Cataract Surgery

Cited by 28 publications

References 5 publications

Patients’ subjective assessment of the duration of cataract surgery: a case series

Patients’ subjective assessment of the duration of cataract surgery: a case series

Lost opportunity cost of surgical training in the Australian private sector

Resident surgical experience with lens and corneal refractive surgery: Survey of the ASCRS Young Physicians and Residents Membership

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