Intra–Operative and Post–Operative Complications in Resident–Performed Cataract Surgery

Abstract

Purpose: : To assess the intra–operative and post–operative complications related to cataract surgery performed by third year ophthalmology residents.

Methods: : A retrospective chart review of all patients who underwent cataract extraction by third year ophthalmology residents between July 2003 and June 2004 at the Institute of Ophthalmology and Visual Science (IOVS), NJ.

Results: : A total of 280 cataract surgeries performed by the third year residents at IOVS during this1–year period were identified. 269 eyes (96.1%) underwent phacoemulsification, 10 eyes (3.6%) extracapsular cataract extraction (ECCE) and 1 (0.4%) intracapsular cataract extraction (ICCE). 242 eyes had a posterior chamber intraocular lens (PC IOL) implanted in the capsular bag, 18 eyes had a PC IOL placed in the sulcus, and 4 had an anterior chamber intraocular lens (AC IOL). 16 eyes were left aphakic at the time of initial surgery. No complications were encountered in patients who underwent ECCE. Eleven cases (4.1%) of vitreous loss were identified due to posterior capsular disruption, during phacoemulsification. Of these eleven cases four were converted to ECCE and one to ICCE. None of the cases with posterior capsular disruption had dislocated lenticular fragments in the vitreous cavity. No patient developed choroidals, retinal detachment or endophthalmitis.

Conclusions: : The rate of vision threatening complications in cataract surgery performed by third year residents at IOVS is low. The rate of complications in this study is much lower than in previous reports of resident cataract surgery in the literature. A larger retrospective study spanning a longer duration is required to truly assess the incidence of vitreous loss, dislocated lens fragments, retinal detachment and choroidals during cataract cases performed by the third year residents.

Keywords: cataract • training/teaching cataract surgery • treatment outcomes of cataract surgery