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Brian J. Song, Bryan J. Winn, Amilia Schrier; Quality Assurance Measures of Resident Cataract Surgery: An Analysis of Trends and Complications. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4734.
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While many studies have examined outcomes of resident cataract surgery, there is no consensus on how best to improve such outcomes among training programs. Beginning in 2005, Quality Assurance (QA) data was collected on all surgical cases in the Department of Ophthalmology at Columbia University Medical Center. The purpose of this study to quantify trends in resident cataract surgery since the inception of the QA data in 2005 at a single institution and to determine if extracapsular cataract surgery (ECCE) is correlated with a decrease in overall phacoemulsification complications the following year.
All information for this study was collected from the QA operative data from 2005 to 2009. Inclusion criteria included any cataract surgery performed by a resident as the primary surgeon during this time period. Exclusion criteria included any other type of surgery or the inclusion of a joint procedure including but not limited to trabeculectomy, keratoplasty, or tube shunts in addition to phacoemulsification. Complicated procedures were defined as those involving vitreous loss.
According to the QA date, a total of 1353 resident cataract surgeries were performed during the study period, of which 1325 were done by phacoemulsification. Of these, 179 (13.5%) were complicated by vitreous loss. ECCE accounted for 2.07% of all resident cataract surgeries, with each resident performing zero to five ECCE during the 2nd year. Overall, a general increase in the number of phacoemulsification procedures performed by residents was seen since 2005. Both the rate of complicated procedures and the overall length of procedures appear to decrease from the first six months to the last six months of the third year of residency training. There was no correlation seen between the number of ECCE done the previous year with the number of phacoemulsification complications the following year.
No correlation was seen between the number of ECCE done during the 2nd year of training and the number of complications associated with resident phacoemulsification in the 3rd year. In addition, improvement and standardization of QA data collection may be beneficial in identifying areas for improvement in both the operating room and residency training program.
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