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Tidarat Prechanond, Marissa Lee, Monique L. Trinidad, Azadeh Khatibi, Travis C. Porco, Ayman Naseri, Jay M. Stewart; Retinal Detachment after Resident-performed Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5810.
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To assess risk factors for retinal detachment following resident-performed cataract surgery.
In this retrospective case-control study, 48 patients who developed retinal detachment (RD) after resident-performed cataract surgeries performed at San Francisco General Hospital and SFVAMC between January 1, 1996, and December 20, 2009, were included as cases. One hundred and ninety two controls were randomly chosen from the list of all cataract surgery patients from this time period who did not develop RD in the ratio of 4 controls per 1 case without case-control matching. Data was collected from medical records and analyzed using univariate analysis to compare the differences between two groups and using multivariate logistic regression analysis to identify variables that were associated with an increased risk of developing RD.
The major variables analyzed included patient age, gender, axial length, vitreous loss, and resident training year. Vitreous loss during cataract surgery and male patient gender were found to be statistically significant risk factors for developing RD with P < 0.001 (OR, 25.9; 95%CI, 6.2-107.7) and P = 0.023 (OR, 5.26; 95%CI, 1.25-25), respectively. Increasing years of resident experience were associated with a reduction in the risk of RD (P = 0.01). There was no statistically significant effect for patient age or axial length, P = 0.5 (OR, 0.99; 95%CI,0.94-1.0) and 0.057 (OR, 1.4; 95%CI, 0.99-1.8), respectively.
Intraoperative vitreous loss and male patient gender were identified as risk factors for RD following resident-performed cataract surgery. The study also found evidence of a resident-year effect on RD development, with more years of training associated with less RD risk. These findings may help direct future quality improvement efforts within resident surgical training programs and can serve as a basis for informed-consent discussions with patients considering cataract surgery with resident surgeons.
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