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Shivali Menda, Todd Driver, Alexandra Neiman, Ayman Naseri, Jay Stewart; Reoperation After Resident-Performed Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2987.
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To examine the rate and indications for reoperation after resident-performed cataract surgery at 30 and 90 days.
All returns to the operating room after resident-performed cataract surgery from 2005-2010 at two teaching hospitals within a single residency training program were studied. Reoperations and matched controls were used to examine the type of primary operation, training level of resident, time to reoperation, indication for reoperation, type of reoperation, and surgical risk factors for reoperation.
There were 70 reoperations out of a total of 3,310 cataract surgeries performed, for a reoperation rate of 2.11%. The reoperation rate at the county hospital was 2.25% while the reoperation rate at the Veterans Affairs (VA) hospital was 1.99%. The most common primary procedure performed was a phacoemulsification with intraocular lens (IOL) placement (88.6%) followed by extracapsular cataract extraction with IOL placement (11.4%). Ten cases (14.3%) that required reoperation were performed by a first-year ophthalmology resident, thirty-eight (54.3%) were performed by a second-year resident, while 22 (31.4%) were performed by a third-year resident. Fourteen (20.0%) occurred in the first quarter of the academic year, 20 (28.6%) occurred in the second quarter, 21 (30.0%) in the third quarter, and 15 (21.4%) in the final quarter of the academic year. Fifty-two (74.3%) reoperations occurred in the first 30 days after the primary cataract surgery while an additional eighteen (25.7%) occurred 31-90 days after the cataract surgery. The most common reasons for reoperation included retained nuclear fragment (32.9%), subluxed or dislocated IOLs (17.1%), incision leak (12.9%), and retinal detachment (11.4%). The most common reoperation procedures were pars plana vitrectomy with pars plana lensectomy (31.4%), incision repair (14.3%), pars plana vitrectomy with membrane peel (12.9%), IOL exchange (11.4%), and IOL repositioning (7.1%).
The reoperation rate for resident-performed cataract surgery is 2.11%. Over 70% of reoperations occur within 30 days of the original cataract surgery. The most common indications for reoperation included retained nuclear fragments, subluxed or dislocated IOLs, incision leaks, and retinal detachment.
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