Complication rate and risk factors for intraoperative complications in resident-performed phacoemulsification surgery

Graefes Arch Clin Exp Ophthalmol. 2012 Sep;250(9):1315-20. doi: 10.1007/s00417-012-2003-y. Epub 2012 Apr 11.

Abstract

Background/aim: To determine the complication rate and risk factors for intraoperative complications in resident-performed phacoemulsification surgery at a tertiary care center during the first 100 surgeries.

Methods: Retrospective chart review of the first 100 performed phacoemulsification cases of six consecutive residents. Posterior capsule tear, vitreous loss, and dislocation of lenticular fragments into the vitreous were defined as intraoperative complications. Patient characteristics considered risk factors for surgery were identified and correlated with the occurrence of intraoperative complications.

Results: Complications occurred in 23 of 600 operations (3.8 %). Surgery was complicated by posterior capsular tear in 23 eyes (3.8 %) with vitreous loss in 17 eyes (2.8 %) and loss of lenticular fragments into the vitreous in seven eyes (1.2 %). Eyes with dense nuclear sclerosis (p = 0.002) and white cataracts (p = 0.019) were associated with a statistically significantly greater incidence of posterior capsular tears and vitreous loss (p = 0.007 and p = 0.027 respectively). An intraocular lens was implanted in 591 eyes as intended.

Conclusions: Residents achieve an acceptable complication rate during their initial 100 phacoemulsification cases.

MeSH terms

  • Aged
  • Clinical Competence / standards*
  • Education, Medical, Graduate / standards*
  • Female
  • Humans
  • Internship and Residency*
  • Intraoperative Complications*
  • Learning Curve
  • Lens Implantation, Intraocular
  • Lens Subluxation / etiology
  • Male
  • Ophthalmology / education*
  • Phacoemulsification / adverse effects*
  • Phacoemulsification / education
  • Posterior Capsule of the Lens / injuries
  • Retrospective Studies
  • Risk Factors
  • Vitreous Body / pathology