Visual outcomes after vitreous loss during cataract surgery performed by residents

Blomquist, Preston H.; Rugwani, Rajiv M.

doi:10.1016/s0886-3350(01)01117-8

Cited by 107 publications

(80 citation statements)

References 23 publications

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“…It is well known that surgical complications, such as posterior capsule disruption with vitreous loss, are significant risk factors for the development of this infection. It is also expected that surgeons-intraining be responsible for more cases developing complication (4) . However, a small case series did not show an increa- sed incidence of endophthalmitis after cataract surgery performed by residents (5) .…”

Section: Discussionmentioning

confidence: 99%

Incidence of endophthalmitis after cataract surgery (2002-2008) at a Brazilian university-hospital

Melo¹,

Bispo²,

Regatieri³

et al. 2010

Arq. Bras. Oftalmol.

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Section: Discussionmentioning

confidence: 99%

Incidence of endophthalmitis after cataract surgery (2002-2008) at a Brazilian university-hospital

Melo¹,

Bispo²,

Regatieri³

et al. 2010

Arq. Bras. Oftalmol.

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“…[5][6][7][8][9] Similar reports also exist for experienced surgeons and for overall surgical programmes, including surgeons of varied levels of experience. [10][11][12] There has, however, been no report of the complication rates of more experienced trainees and as such no suitable benchmark exists for cataract surgical audit by individual trainee surgeons themselves, or by those charged with their ongoing training.…”

Section: Introductionmentioning

confidence: 92%

Determinants of cataract surgical opportunities and complication rates in UK higher specialist training

Cassels-Brown

2008

Eye

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Purpose The volume of cataract surgery performed by trainee ophthalmologists in the UK, and the complication rates experienced by those trainees is unknown. As a result, no appropriate audit benchmark exists for trainees or their trainers. This study describes the surgical opportunities and rates of posterior capsule rupture (PCR) experienced by higher specialist trainees in one UK training region and explores influencing factors. Methods Number of cataract operations and episodes of PCR in each calendar month were recorded from surgical logbooks for all Specialist Registrars (SpRs) who had completed at least 6 months of training by January 2007. Dates and details of the posts in which the surgery was performed were also recorded. Results Data from 475 completed months were collected from 19 trainees including 4322 cataract operations and 99 episodes of PCR. Trainees performed a mean 9.1 operations per month. This varied significantly between different subspeciality posts; the fewest cataracts were on paediatric and oculo-plastic firms. District General Hospitals offered more surgery than Teaching Hospitals; mean 10.9 vs 8.5 cataracts per month (P ¼ 0.005). No difference in surgical opportunity was found between male and female trainees. An overall PCR rate of 2.3% (95% CI 2.25-2.33%) was found, which decreased significantly with increasing experience (Po0.01). Conclusion SpRs in Yorkshire expect to complete around 500 cataract operations in their 4.5 years of training. A PCR rate of 2.3% was found for trainees with a mean of 25 months higher specialist training which compares favourably with published series of trainees from other countries.

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“…Cinco desses casos ocorreram em olhos com pupila pequena e dois em olhos com esclerose nuclear de 4+. Após esses estudos, vários outros relataram bons resultados da cirurgia de facoemulsificação realizada por residentes (3)(4)(5)(6)(7)(8)(9) (Tabela1), comparáveis aos de cirurgiões experientes, também no início das suas curvas de aprendizado da facoemulsificação (10)(11)(12)(13) .…”

Section: Uma Breve Revisão Da Literaturaunclassified

O professor e o estudante na facoemulsificação: os dez princípios para o sucesso

Ghanem¹,

Mannis²

2003

Arq. Bras. Oftalmol.

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Neste texto, os autores apresentam os diferentes aspectos do aprendizado da cirurgia de facoemulsificação pelo cirurgião iniciante. Discutem também o papel do professor e do aluno no ambiente da "Sala de Aula Cirúrgica", sugerindo alguns princípios que melhor fundamentam o aprendizado cirúrgico, reduzindo complicações e proporcionando maior segurança para o paciente. Gawande, Metropolitan Books, New York, 2002] O ensinamento cirúrgico representa um desafio, tanto para o orientador, que leva à sala cirúrgica sua experiência e o conhecimento de como lidar com as situações inesperadas, quanto para o cirurgião iniciante, que está meramente tentando aprender os passos básicos de um procedimento. O cirurgião iniciante deve não apenas compreender os problemas intelectuais e cognitivos que fundamentam um procedimento cirúrgico, mas, também, dominar os aspectos técnicos, com treinamento freqüente no ambiente cirúrgico. Diferente de outras funções cognitivas da medicina, a obtenção bem sucedida da habilidade cirúrgica requer experiência prática, preferencialmente sob supervisão de um cirurgião experiente.Por outro lado, o paciente que vai a uma sala de cirurgia quer estar confiante nas mãos de um cirurgião, na certeza de que o médico saberá realizar a cirurgia proposta e, conseqüentemente, não lhe causará dano algum. Isso representa um dilema para o estudante e para o professor. Este deve ter muito equilíbrio na hora de permitir ao cirurgião iniciante familiarizar-se com os passos cirúrgicos (habilidade de julgamento e experiência técnica) e, ao mesmo tempo, proteger o paciente dos erros da inexperiência. Essa decisão se torna ainda mais importante no contexto da facoemulsificação, procedimento seqüencial interdependente em que há pouco lugar para erro.Neste texto, temos como objetivo prover, a estudantes e docentes de facoemulsificação, diretrizes que poderão facilitar o aprendizado do novo cirurgião e proporcionar maior segurança para o paciente.

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Visual outcomes after vitreous loss during cataract surgery performed by residents

Abstract: Good visual acuity can be achieved after resident cataract surgery complicated by vitreous loss. The rate of vitreous loss in this study is consistent with that in previous reports of resident cataract surgery in the literature.

Cited by 107 publications

References 23 publications

Incidence of endophthalmitis after cataract surgery (2002-2008) at a Brazilian university-hospital

Incidence of endophthalmitis after cataract surgery (2002-2008) at a Brazilian university-hospital

Determinants of cataract surgical opportunities and complication rates in UK higher specialist training

O professor e o estudante na facoemulsificação: os dez princípios para o sucesso

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