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Assessment of perceived difficulties by residents in performing routine steps in phacoemulsification surgery and in
Gaurav Prakash1, Vishal Jhanji, Namrata Sharma
1Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. drgauravprakash@gmail.com
Objective:
To analyze the perceived difficulties of residents in performing the routine steps of phacoemulsification surgery and in managing complications.
Design:
Cross-sectional questionnaire-based study.
Participants:
Thirty-six residents performing phacoemulsification during their learning curve.
Methods:
On an 8-point Likert scale, residents noted comfort levels with various steps of cataract surgery and with managing complications.
Results:
The respondents were grouped into Group 1 (second-year residents, n = 19) and Group 2 (third-year residents, n = 17). Residents in Group 2 had greater surgical experience than residents in Group 1 (p = 0.001). The most difficult step in cases of phacoemulsification for Group 1 was loading a foldable intraocular lens (IOL) (mean score 6.05, SD 1.57), and for Group 2 it was nuclear emulsification (mean score 3.59, SD 1.42). Both second- and third-year residents found capsular bag dialysis the most difficult complication (mean scores 6.0 [SD 1.9] and 5.75 [SD 2.14], respectively). The second-year residents had significantly more difficulty with errant capsulorrhexis, anterior chamber IOL placement, and repeated iris prolapse as compared with third-year residents. Group 2 residents reported that mature, senile cataracts were the most difficult cases for them to manage (mean score 6.23, SD 1.56).
Conclusions:
This study identifies perceived difficulties that residents experience in routine cases of cataract surgery, highlighting specific areas in which they may benefit from additional training and practice.
