Comparing Resident Outcomes in Cataract Surgery at Different Levels of Experience

Mathias V Melega,1 Rodrigo Pessoa Cavalcanti Lira,2 Iuri Cardoso da Silva,1 Bruna Gil Ferreira,1 Hermano LG Assis Filho,1 Alexandre AF Martini,1 Roberto dos Reis,1 Carlos Eduardo Leite Arieta,1 Monica Alves1 1School of Medical Sciences, Ophthalmology Department of University of Campinas (UNICAMP), C...

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Autores principales:	Melega MV, Pessoa Cavalcanti Lira R, da Silva IC, Ferreira BG, Assis Filho HLG, Martini AAF, dos Reis R, Arieta CEL, Alves M
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	cataract phacoemulsification complications practicing surgeons surgical education ophthalmology residency Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/a1850c7d75324a138d62ef898caa381e
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spelling	oai:doaj.org-article:a1850c7d75324a138d62ef898caa381e2021-12-02T12:01:06ZComparing Resident Outcomes in Cataract Surgery at Different Levels of Experience1177-5483https://doaj.org/article/a1850c7d75324a138d62ef898caa381e2020-12-01T00:00:00Zhttps://www.dovepress.com/comparing-resident-outcomes-in-cataract-surgery-at-different-levels-of-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Mathias V Melega,1 Rodrigo Pessoa Cavalcanti Lira,2 Iuri Cardoso da Silva,1 Bruna Gil Ferreira,1 Hermano LG Assis Filho,1 Alexandre AF Martini,1 Roberto dos Reis,1 Carlos Eduardo Leite Arieta,1 Monica Alves1 1School of Medical Sciences, Ophthalmology Department of University of Campinas (UNICAMP), Campinas, São Paulo, Brazil; 2School of Medical Sciences, Ophthalmology Department of Federal University of Pernambuco (UFPE), Recife, Pernambuco, BrazilCorrespondence: Mathias V MelegaSchool of Medical Sciences, University of Campinas (UNICAMP), Rua Dona Josefina Sarmento 120, Ap 71, Cambuí, Campinas, SP CEP 13025-260, BrazilTel +55 19 997513150Email mvmelega@hotmail.comPurpose: To evaluate outcomes of resident-performed cataract surgeries in different training levels in a retrospective case series.Patients and Methods: A total of 730 surgeries performed by residents were evaluated into three groups: surgeries performed during residents’ first semester of training in phacoemulsification (Level 1 – L1), surgeries performed during the second semester (Level 2 – L2), and surgeries performed during the third semester (Level 3 – L3). The primary outcome was the incidence of intraoperative complications in each group. Secondary outcomes were the comparisons between initial and final corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell density (ECD), and central corneal thickness (CCT) in each group. Descriptive statistical analyses were employed in the presentation of the results using central tendency and variance measurements.Results: The rate of complications within six weeks of follow-up was 24 out of 102 eyes (23.53%) in the L1 group, 63 out of 301 eyes (20.93%) in the L2 group, and 37 out of 327 (11.31%) in the L3 group (p=0.001). Posterior capsule rupture (PCR) was the most frequent intercurrence observed in all three semesters: it occurred in 12.7% of the surgeries in the first semester (13/102), 16.9% of surgeries in the second semester (51/301), and 9.5% of surgeries in the third semester (31/327). There was no significant difference in CDVA (p=0.298), ECD (p=0.067), IOP (p=0.217), or CCT (p=0.807) between the groups.Conclusion: When measured by rates of complications and by the aforementioned parameters, surgical competency was found to improve as surgical experience and frequency increased. Therefore, this study identified some patterns of skill development that can be applied to teaching strategies and better assist surgeons in training.Keywords: cataract, phacoemulsification, complications, practicing surgeons, surgical education, ophthalmology residencyMelega MVPessoa Cavalcanti Lira Rda Silva ICFerreira BGAssis Filho HLGMartini AAFdos Reis RArieta CELAlves MDove Medical Pressarticlecataractphacoemulsificationcomplicationspracticing surgeonssurgical educationophthalmology residencyOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 4523-4531 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	cataract phacoemulsification complications practicing surgeons surgical education ophthalmology residency Ophthalmology RE1-994
spellingShingle	cataract phacoemulsification complications practicing surgeons surgical education ophthalmology residency Ophthalmology RE1-994 Melega MV Pessoa Cavalcanti Lira R da Silva IC Ferreira BG Assis Filho HLG Martini AAF dos Reis R Arieta CEL Alves M Comparing Resident Outcomes in Cataract Surgery at Different Levels of Experience
description	Mathias V Melega,1 Rodrigo Pessoa Cavalcanti Lira,2 Iuri Cardoso da Silva,1 Bruna Gil Ferreira,1 Hermano LG Assis Filho,1 Alexandre AF Martini,1 Roberto dos Reis,1 Carlos Eduardo Leite Arieta,1 Monica Alves1 1School of Medical Sciences, Ophthalmology Department of University of Campinas (UNICAMP), Campinas, São Paulo, Brazil; 2School of Medical Sciences, Ophthalmology Department of Federal University of Pernambuco (UFPE), Recife, Pernambuco, BrazilCorrespondence: Mathias V MelegaSchool of Medical Sciences, University of Campinas (UNICAMP), Rua Dona Josefina Sarmento 120, Ap 71, Cambuí, Campinas, SP CEP 13025-260, BrazilTel +55 19 997513150Email mvmelega@hotmail.comPurpose: To evaluate outcomes of resident-performed cataract surgeries in different training levels in a retrospective case series.Patients and Methods: A total of 730 surgeries performed by residents were evaluated into three groups: surgeries performed during residents’ first semester of training in phacoemulsification (Level 1 – L1), surgeries performed during the second semester (Level 2 – L2), and surgeries performed during the third semester (Level 3 – L3). The primary outcome was the incidence of intraoperative complications in each group. Secondary outcomes were the comparisons between initial and final corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell density (ECD), and central corneal thickness (CCT) in each group. Descriptive statistical analyses were employed in the presentation of the results using central tendency and variance measurements.Results: The rate of complications within six weeks of follow-up was 24 out of 102 eyes (23.53%) in the L1 group, 63 out of 301 eyes (20.93%) in the L2 group, and 37 out of 327 (11.31%) in the L3 group (p=0.001). Posterior capsule rupture (PCR) was the most frequent intercurrence observed in all three semesters: it occurred in 12.7% of the surgeries in the first semester (13/102), 16.9% of surgeries in the second semester (51/301), and 9.5% of surgeries in the third semester (31/327). There was no significant difference in CDVA (p=0.298), ECD (p=0.067), IOP (p=0.217), or CCT (p=0.807) between the groups.Conclusion: When measured by rates of complications and by the aforementioned parameters, surgical competency was found to improve as surgical experience and frequency increased. Therefore, this study identified some patterns of skill development that can be applied to teaching strategies and better assist surgeons in training.Keywords: cataract, phacoemulsification, complications, practicing surgeons, surgical education, ophthalmology residency
format	article
author	Melega MV Pessoa Cavalcanti Lira R da Silva IC Ferreira BG Assis Filho HLG Martini AAF dos Reis R Arieta CEL Alves M
author_facet	Melega MV Pessoa Cavalcanti Lira R da Silva IC Ferreira BG Assis Filho HLG Martini AAF dos Reis R Arieta CEL Alves M
author_sort	Melega MV
title	Comparing Resident Outcomes in Cataract Surgery at Different Levels of Experience
title_short	Comparing Resident Outcomes in Cataract Surgery at Different Levels of Experience
title_full	Comparing Resident Outcomes in Cataract Surgery at Different Levels of Experience
title_fullStr	Comparing Resident Outcomes in Cataract Surgery at Different Levels of Experience
title_full_unstemmed	Comparing Resident Outcomes in Cataract Surgery at Different Levels of Experience
title_sort	comparing resident outcomes in cataract surgery at different levels of experience
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/a1850c7d75324a138d62ef898caa381e
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Comparing Resident Outcomes in Cataract Surgery at Different Levels of Experience

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