Induced Astigmatism After Phacoemulsification Surgery Performed By First Year Residents

Abstract

 

Purpose:

 

To determine induced astigmatism during the first year of surgical training in a residency program with clear cornea incision for phacoemulsification and compare it against astigmatism induced by an experienced surgeon using the same technique.

 

Methods:

 

We reviewed clinical records of 90 consecutive patients who underwent cataract surgery with phacoemulsification between November 2009 and October 2010. Fifty-two patients were operated on by first year residents and 38 by an expert surgeon. All patients received clear cornea incision with a 2.8 mm blade. Preoperative keratometric astigmatism between 1 and 10 days before surgery and 1 month after surgery were compared. Ten patients received a 10-0 Nylon stitch for proper wound closure, and keratometric values were taken after stitch removal.

 

Results:

 

In the resident intervention group, average astigmatism induction was 1.48+/- 0.62 Dioptres (D). Right eye average was 1.46 D and left eye 1.52 D. In the expert intervention group, average astigmatism induction was 1.28 D +/-0.34. Right eye average was 1.27 and left eye 1.30 D.

 

Conclusions:

 

Astigmatism induction with the same technique was higher when surgery was performed by surgeons under training. Right vs. left difference was also more significant in the resident intervention group. Expert surgeons tend to develop a more standardized incision technique that leads to a reduction in induced astigmatism as well as in the difference between eyes.It is important for young surgeons to know that induced astigmatism and its variability between both eyes may be helpful to monitor the progress in wound architecture and surgical technique.  

 

Keywords: cataract • astigmatism