A Comparative Assessment of Intraoperative Complication Rates in Resident-Performed Phacoemulsification Surgeries According to Najjar-Awwad Preoperative Risk Stratification

Hamid Gharaee, Masoud Jahani, Saeed Banan Eye Research Center, Mashhad University of Medical Sciences, Mashhad, IranCorrespondence: Masoud Jahani Tel +98 9111760280Email Jahani.Masoud@yahoo.comIntroduction: Phacoemulsification cataract surgery presents a challenge to resident surgeons with lower exp...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Gharaee H, Jahani M, Banan S
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	phacoemulsification preoperative risk intraoperative complications resident Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/57036af9812b455ebeeba19c6c7d156f
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:57036af9812b455ebeeba19c6c7d156f
record_format	dspace
spelling	oai:doaj.org-article:57036af9812b455ebeeba19c6c7d156f2021-12-02T10:14:29ZA Comparative Assessment of Intraoperative Complication Rates in Resident-Performed Phacoemulsification Surgeries According to Najjar-Awwad Preoperative Risk Stratification1177-5483https://doaj.org/article/57036af9812b455ebeeba19c6c7d156f2020-05-01T00:00:00Zhttps://www.dovepress.com/a-comparative-assessment-of-intraoperative-complication-rates-in-resid-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Hamid Gharaee, Masoud Jahani, Saeed Banan Eye Research Center, Mashhad University of Medical Sciences, Mashhad, IranCorrespondence: Masoud Jahani Tel +98 9111760280Email Jahani.Masoud@yahoo.comIntroduction: Phacoemulsification cataract surgery presents a challenge to resident surgeons with lower experience, which confronts with patient safety. In this study, we compared major intraoperative surgical complications of resident-performed phacoemulsification surgeries between cases with low intraoperative risk and random cases with unknown intraoperative risk.Methods: This prospective randomized controlled study was done on patients who underwent phacoemulsification surgery by third- and fourth-year residents in Khatam-al-Anbia eye hospital, Mashhad, Iran. Preoperative risk was calculated using Najjar-Awwad risk score after slit lamp examination and the patients with scores 7 or higher were considered high-risk. Patients were randomly assigned into a study group, in which only low-risk cases were operated by third-year residents, or control group, in which third-year residents were able to operate any patient regardless of the risk score. In both groups, the remaining patients were operated by fourth-year residents. All intraoperative complications were recorded. Data were analyzed using SPSS, considering P< 0.05 significant.Results: Overall, 475 patients with cataract in the study (N=232) and control (N=243) groups were operated. Mean overall Najjar-Awwad risk scores did not differ significantly between the groups, but pseudoexfoliation and poor pupil dilatation occurred significantly more frequently in the control group (P=0.010 and P=0.014, respectively). Overall, 36 surgeries in the study group (15.5%) and 47 surgeries in the control group (19.3%) were complicated (P=0.273). There was a significant difference between the third- and fourth-year residents regarding the inability to complete continuous curvilinear capsulorhexis (P=0.033). The risk of overall and major complications in high-risk cases was significantly higher among those operated by 3rd-year residents compared with those operated by 4th-year residents (OR=3.45, 95% CI=1.2– 9.9, P=0.016 and OR=6.37, 95% CI=1.99– 20.34, P=0.001, respectively).Conclusion: Although supervised resident-performed phacoemulsification has a relatively safe learning curve in our residency program, it is best to stratify preoperative risk and assign high-risk cases to senior residents with higher experience.Keywords: phacoemulsification, preoperative risk, intraoperative complications, residentGharaee HJahani MBanan SDove Medical Pressarticlephacoemulsificationpreoperative riskintraoperative complicationsresidentOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 1329-1336 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	phacoemulsification preoperative risk intraoperative complications resident Ophthalmology RE1-994
spellingShingle	phacoemulsification preoperative risk intraoperative complications resident Ophthalmology RE1-994 Gharaee H Jahani M Banan S A Comparative Assessment of Intraoperative Complication Rates in Resident-Performed Phacoemulsification Surgeries According to Najjar-Awwad Preoperative Risk Stratification
description	Hamid Gharaee, Masoud Jahani, Saeed Banan Eye Research Center, Mashhad University of Medical Sciences, Mashhad, IranCorrespondence: Masoud Jahani Tel +98 9111760280Email Jahani.Masoud@yahoo.comIntroduction: Phacoemulsification cataract surgery presents a challenge to resident surgeons with lower experience, which confronts with patient safety. In this study, we compared major intraoperative surgical complications of resident-performed phacoemulsification surgeries between cases with low intraoperative risk and random cases with unknown intraoperative risk.Methods: This prospective randomized controlled study was done on patients who underwent phacoemulsification surgery by third- and fourth-year residents in Khatam-al-Anbia eye hospital, Mashhad, Iran. Preoperative risk was calculated using Najjar-Awwad risk score after slit lamp examination and the patients with scores 7 or higher were considered high-risk. Patients were randomly assigned into a study group, in which only low-risk cases were operated by third-year residents, or control group, in which third-year residents were able to operate any patient regardless of the risk score. In both groups, the remaining patients were operated by fourth-year residents. All intraoperative complications were recorded. Data were analyzed using SPSS, considering P< 0.05 significant.Results: Overall, 475 patients with cataract in the study (N=232) and control (N=243) groups were operated. Mean overall Najjar-Awwad risk scores did not differ significantly between the groups, but pseudoexfoliation and poor pupil dilatation occurred significantly more frequently in the control group (P=0.010 and P=0.014, respectively). Overall, 36 surgeries in the study group (15.5%) and 47 surgeries in the control group (19.3%) were complicated (P=0.273). There was a significant difference between the third- and fourth-year residents regarding the inability to complete continuous curvilinear capsulorhexis (P=0.033). The risk of overall and major complications in high-risk cases was significantly higher among those operated by 3rd-year residents compared with those operated by 4th-year residents (OR=3.45, 95% CI=1.2– 9.9, P=0.016 and OR=6.37, 95% CI=1.99– 20.34, P=0.001, respectively).Conclusion: Although supervised resident-performed phacoemulsification has a relatively safe learning curve in our residency program, it is best to stratify preoperative risk and assign high-risk cases to senior residents with higher experience.Keywords: phacoemulsification, preoperative risk, intraoperative complications, resident
format	article
author	Gharaee H Jahani M Banan S
author_facet	Gharaee H Jahani M Banan S
author_sort	Gharaee H
title	A Comparative Assessment of Intraoperative Complication Rates in Resident-Performed Phacoemulsification Surgeries According to Najjar-Awwad Preoperative Risk Stratification
title_short	A Comparative Assessment of Intraoperative Complication Rates in Resident-Performed Phacoemulsification Surgeries According to Najjar-Awwad Preoperative Risk Stratification
title_full	A Comparative Assessment of Intraoperative Complication Rates in Resident-Performed Phacoemulsification Surgeries According to Najjar-Awwad Preoperative Risk Stratification
title_fullStr	A Comparative Assessment of Intraoperative Complication Rates in Resident-Performed Phacoemulsification Surgeries According to Najjar-Awwad Preoperative Risk Stratification
title_full_unstemmed	A Comparative Assessment of Intraoperative Complication Rates in Resident-Performed Phacoemulsification Surgeries According to Najjar-Awwad Preoperative Risk Stratification
title_sort	comparative assessment of intraoperative complication rates in resident-performed phacoemulsification surgeries according to najjar-awwad preoperative risk stratification
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/57036af9812b455ebeeba19c6c7d156f
work_keys_str_mv	AT gharaeeh acomparativeassessmentofintraoperativecomplicationratesinresidentperformedphacoemulsificationsurgeriesaccordingtonajjarawwadpreoperativeriskstratification AT jahanim acomparativeassessmentofintraoperativecomplicationratesinresidentperformedphacoemulsificationsurgeriesaccordingtonajjarawwadpreoperativeriskstratification AT banans acomparativeassessmentofintraoperativecomplicationratesinresidentperformedphacoemulsificationsurgeriesaccordingtonajjarawwadpreoperativeriskstratification AT gharaeeh comparativeassessmentofintraoperativecomplicationratesinresidentperformedphacoemulsificationsurgeriesaccordingtonajjarawwadpreoperativeriskstratification AT jahanim comparativeassessmentofintraoperativecomplicationratesinresidentperformedphacoemulsificationsurgeriesaccordingtonajjarawwadpreoperativeriskstratification AT banans comparativeassessmentofintraoperativecomplicationratesinresidentperformedphacoemulsificationsurgeriesaccordingtonajjarawwadpreoperativeriskstratification
_version_	1718397460504641536

A Comparative Assessment of Intraoperative Complication Rates in Resident-Performed Phacoemulsification Surgeries According to Najjar-Awwad Preoperative Risk Stratification

Ejemplares similares