June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Efficacy of Preoperative Risk Stratification of Resident Phacoemulsification Surgery
Author Affiliations & Notes
  • Omar Moussa
    Ophthalmology, Edward S Harkness Eye Institute, New York, New York, United States
    Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States
  • Tahvi Frank
    Columbia University Vagelos College of Physicians and Surgeons, New York, New York, United States
  • Ives A. Valenzuela
    Ophthalmology, Edward S Harkness Eye Institute, New York, New York, United States
    Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States
  • Joah Aliancy
    Ophthalmology, Edward S Harkness Eye Institute, New York, New York, United States
    Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States
  • Dan Gong
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Lora R. Dagi Glass
    Ophthalmology, Edward S Harkness Eye Institute, New York, New York, United States
    Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States
  • Bryan Winn
    Ophthalmology, University of California San Francisco, San Francisco, California, United States
  • George A. Cioffi
    Ophthalmology, Edward S Harkness Eye Institute, New York, New York, United States
    Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States
  • Royce Chen
    Ophthalmology, Edward S Harkness Eye Institute, New York, New York, United States
    Ophthalmology, Columbia University Irving Medical Center, New York, New York, United States
  • Footnotes
    Commercial Relationships   Omar Moussa, None; Tahvi Frank, None; Ives A. Valenzuela, None; Joah Aliancy, None; Dan Gong, None; Lora Dagi Glass, Thieme Medical Publishers (C); Bryan Winn, None; George Cioffi, Research to Prevent Blindness (F); Royce Chen, Carl Zeiss Meditec, Inc. (C)
  • Footnotes
    Support  National Eye Institute Core Grant P30EY019007
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 590. doi:
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    • Get Citation

      Omar Moussa, Tahvi Frank, Ives A. Valenzuela, Joah Aliancy, Dan Gong, Lora R. Dagi Glass, Bryan Winn, George A. Cioffi, Royce Chen; Efficacy of Preoperative Risk Stratification of Resident Phacoemulsification Surgery. Invest. Ophthalmol. Vis. Sci. 2021;62(8):590.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : This study determines how a novel cataract surgery grading system at a single U.S. teaching institution may predict intra-operative complications and post-operative outcomes.

Methods : This is a retrospective observational study on non-consecutive cataract surgical cases performed by residents at Columbia University Irving Medical Center/Edward S. Harkness Eye Institute. Risk scores (Table), preoperative best-corrected visual acuity (BCVA), intra-operative complications, post-operative day 1 (POD1) and month 1 (POM1) BCVA, and POM1 exam findings were tabulated. Risk scores were used to stratify cases among residents at different levels of training. The relationship between preoperative risk scores and POD1/POM1 BCVA was modeled using linear regression. The relationship between preoperative risk scores and rates of each type of complication was modeled using logistic regression. Logistic regression was used to model the rates of complications across different levels of training, and odds ratios were calculated before and after adjusting for case mix using risk scores.

Results : Data was collected on 530 cases from January 2017 to May 2020 and risk scores ranged from 0 to 8 (mean = 1.31). Mean POM1 visual acuity was 0.37 LogMAR, and 80% of cases had visual acuity equal to or better than 20/30 at POM1. Average POM1 visual acuity for cases that had posterior capsular rupture was 0.56. Risk scores did not have a significant association with posterior capsule rupture. Risk scores were predictive of corneal edema (OR = 1.36, p = 0.0032), having any POM1 complication (OR = 1.20, p = 0.034), and having any complication overall (OR = 1.21, p = 0.014). Risk scores were also predictive of POD1 (β = 0.13, p < 0.0001) and POM1 (β = 0.057, p = 0.00048) visual acuity. There was not a significant association between level of training and rates of intra-operative or post-operative complications, both before and after adjusting for case mix (p > 0.05).

Conclusions : Our pre-operative cataract surgical risk score was highly correlated with post-operative visual acuity and the presence of POM1 corneal edema. Risk scores were also predictive for any POM1 complication and any complication overall. Rates of complications were not correlated to the year of training, both before and after adjusting for the risk score.

This is a 2021 ARVO Annual Meeting abstract.

 

Risk Stratification Table

Risk Stratification Table

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