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Adam Dao, Kenneth Cohen; Phacoemulsificaton Cataract Extraction Complication Rates of Second- and Third-Year Residents at a High Volume Academic Center in North Carolina with a Integrated, Intensive Surgical Curriculum. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2816.
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To determine how a intensive surgical curriculum combined with a unique approach to cataract surgery timing in resident education where over half of cataract surgeries are performed by second-year residents (PGY3) affects complication rates during phacoemulsification cataract surgery. The complication measured is whether or not there was an intact posterior capsule at the end of the surgical case. In the majority of training programs across the country, the vast majority of cataract extractions are performed by third-year residents (PGY4).
This is a Retrospective Chart review of all patients receiving cataract surgery by a second (PGY3) or third year (PGY4) resident at the University of North Carolina over a one-year period from 12/2012 to 11/2013. During this period, 277 phacoemulsification cataract extractions were performed by residents; 163 were performed by second-year residents and 114 were performed by third-year residents. The posterior capsule tear rate was measured as a percentage of total cases by reviewing the dictated operative reports for each of the cases.
In a residency training program where significant numbers of cataract extractions are performed by the second-year residents, there was a significant difference between complication rates of second- and third-year residents. The rate of posterior capsule rupture for second-year residents was 11.0%. The rate of posterior capsule rupture for third-year residents was 3.5%. Second-year residents have significantly more complication rates than third-year residents (p<0.05).
The surgical curriculum at the University of North Carolina, which includes lecture), wet-lab instruction, and surgery on patients over the entire three-year resident education period significantly reduces the complication rate of phacoemulsification cataract extraction between the second (PGY3) and the third year of ophthalmology residency (PGY4) training. The cataract education program at UNC could be used as a model for other residency programs across the country.
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