Cataract Surgery Outcomes From a Resident Training in a Low-Resource Setting in the Pacific

The aim of the study was to assess the overall quality of the cataract surgeries performed by a single resident during training in a core surgical competency in a low-resource environment.

This was a retrospective cohort review of cataract surgeries performed by a single surgeon.

A retrospective chart review of all consecutive cases of cataract surgery, in patients older than age 20, performed by 1 resident during the residency period was undertaken. The low-resource residency training program was based in Suva, Fiji, and provided outreach services to other Pacific Islands. The main outcome measures were visual outcomes and sentinel complications in terms of World Health Organization recommendations and reports from high- and low-resource settings that were used as quality benchmarks.

Complete data were available for 95% (670) of cataract surgeries. Five hundred eighty-nine patients (87.9%) had preoperative vision worse than 6/60. Three hundred eighty-seven surgeries (53.6%) were performed on outreach. Five hundred eighty-three (87%) achieved final postoperative best-corrected visual acuity of 6/18 or greater. The overall sentinel complication rate was 4% (26) and comprised posterior capsule rupture 2.7% (18), vitreous loss 1% (7), and endophthalmitis 0.15% (1).

Visual outcomes and sentinel complication rates were comparable not only with World Health Organization recommendations but also with other low- and high-resource environment training programs.