Abstract
Purpose :
Literature shows that the number of surgeries performed is inversely correlated with surgical complications. We performed a retrospective chart review comparing the rate of posterior capsule rupture (PCR) to the total volume of surgeries performed by each of twenty-four cataract surgeons from 2018 to October 2022.
Methods :
The practice management system of the Cleveland Eye and Laser Surgery Center was used to tabulate the cataract volume of twenty-four surgeons from 2018 to October 2022. To be included in this study, each surgeon completed at least 70 cataract surgeries over the period at the center. Intraoperative incident reports were reviewed for each cataract surgeon that qualified. The occurrence of PCR, regardless of cause or classification, was totaled for each of the twenty-four surgeons. The surgeons were divided into two equal groups of twelve based upon the total volume of cases that they completed with a cutoff for the groups being 445 cases. The median, range, mean, and standard deviation (SD) of the total volume and percentage of occurrence of PCR over the period were calculated and compared using a paired t test.
Results :
A total of 16,364 cataract surgeries were performed with a median, range, mean, and SD of 356, 3390-72, 680, and ±791 per surgeon. Of the 16,364 cases, 86 were complicated by PCR (0.53%) at the surgery center over the period with a median, range, mean, and SD of percentage of occurrence of PCR of 0.77%, 2.66-0.00%, 0.82%, and ±0.69% per surgeon. The twelve high volume surgeons completed 14,349 cases with a mean case number of 1,196 ±850 per surgeon. The twelve lower volume surgeons completed 1,964 cases with a mean case number of 164 ±70 per surgeon (p=0.0004). The mean rate of PCR was calculated to be 0.67% ±0.52% and 0.97% ±0.82% for the high and low volume groups of cataract surgeons, respectively (p=0.05). Additionally, all five of the surgeons who performed greater than 1,145 (1,928 ±891) cases were found to have a mean rate of 0.18% ±0.13% PCR complications (p=0.026).
Conclusions :
The higher volume group of cataract surgeons have a significantly larger number of cases and also appear to have a significantly lower mean rate of PCR complications compared to the lower volume group of cataract surgeons. Furthermore, the five highest volume surgeons seem to have a significantly lower rate of PCR complication compared to the low volume group.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.