Resident cataract surgical training in United States residency programs

A comprehensive survey was sent to the residency directors of 129 ophthalmology training programs in the United States. Forty percent of residents gained experience as primary surgeon during their first year; 43% performed only part of the surgery. Seventy-three percent began learning cataract extraction using the extracapsular cataract extraction (ECCE) technique, 24% began with phacoemulsification, and 2% began with either method. If beginning with ECCE, 18% must have completed more than 10 before moving to phacoemulsification, 37% more than 5, and 45% more than 1. Seventy-five percent learned various phacoemulsification techniques; 25% learned only 1 technique. If beginning with 1 technique, 44% began with the scleral tunnel combined with divide and conquer. Sixty-four percent learned phacoemulsification on the Alcon Legacy, 21% on the Alcon Legacy and Storz Millennium, and 6% on the Storz Millennium. Sixty-eight percent of residents rotated out of their main facility to perform cataract surgery. The mean and median number of cataract procedures a resident completed by the end of training was 113 and 100, respectively.