Abstract
Purpose :
Cumulative Dissipated Energy (CDE) is the amount of ultrasound energy used during phacoemulsification (PHACO). We carried out a cross-sectional study to prove that the higher the number of PHACOS, the less CDE was used by the ophthalmic surgeon.
Methods :
We conducted a cross-sectional, data was obtained from a training residency program from August 2020 to November 2020. Patients undergoing surgery with LOCS III nuclear opalescence, grades 2 and 3 (NO2 and NO3), were consecutively included. Exclusion criteria included patients with one functional eye, zonular weakness, congenital and traumatic cataracts. Three groups were created: group 1, less than 80 surgeries performed, group 2 between 80 and 160 surgeries, and group 3 more than 160 surgeries.All patients were operated on the same PHACO platform, the Alcon Centurion system. Statistical analysis was performed with SPSS (Ver. 22. IBM Corp. Armonk, USA). The CDE between the groups was compared with the Bonferroni post hoc analysis.
Results :
One hundred and thirty-five eyes of 135 patients were included, 45 eyes per group, 54.1% (n = 73) were right eyes. The median CDE was 11.5, 10.4, and 7.4 in groups 1, 2, and 3, respectively. The interquartile range, the minimum and maximum values of CDE per group are shown in Table 1. When comparing the three groups, it was found that the surgeon with more experience used less CDE (p = 0.014). (Figure 1) When comparing groups, there were no significant differences between group 1 vs. group 2 (p=0.61) or when comparing group 2 vs. group 3 (p = 0.2). Nevertheless, there was a significant difference when comparing group 1 with group 3 (p=0.006).
Conclusions :
The final amount of CDE may be helpful to measure surgical progress in trainee residents, as it may be directly related to the efficacy of the surgical technique and could be a reliable parameter to predict future outcomes of postoperative inflammation. More than 160 surgeries are required to achieve CDE reduction compared to more experienced surgeons. Most training centers consider this parameter and provide residents with the number of surgeries required to achieve a benchmark for the PHACO learning curve. The CDE is an important variable to evaluate the progress of an ophthalmologist in training, so it would be a valuable parameter to evaluate the progress that he has during his surgical training.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.