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Related Experiment Videos

Analysis of competency in phacoemulsification trainees using the cumulative sum analysis.

Nicole Shu-Wen Chan1, Aliza Jap1, Younian Yang1

  • 1From Singapore General Hospital (Chan), Division of Ophthalmology (Jap), Changi General Hospital, Singapore National Eye Centre (Jap, Yang, Chee), Singapore Eye Research Institute (Tan, Chee), the Department of Ophthalmology (Chee), Yong Loo Lin School of Medicine, National University of Singapore, and Duke-National University of Singapore Graduate Medical School Singapore (Chee), Singapore.

Journal of Cataract and Refractive Surgery
|April 16, 2017
PubMed
Summary

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Determining surgical competency in phacoemulsification requires significant case experience. Most trainees needed over 100 cases to achieve a 5% posterior capsule rupture rate, with many requiring over 200 for a 2% rate.

Area of Science:

  • Ophthalmology
  • Surgical Education
  • Microsurgery

Background:

  • Phacoemulsification is a standard cataract surgery technique.
  • Defining objective competency metrics is crucial for surgical training.
  • Posterior capsule rupture (PCR) is a key indicator of surgical proficiency.

Purpose of the Study:

  • To establish the number of phacoemulsification cases needed to achieve surgical competency.
  • To define competency based on posterior capsule rupture rates.
  • To analyze trainee performance variation in cataract surgery.

Main Methods:

  • Retrospective cohort study analyzing 300 phacoemulsification cases per trainee.
  • Cumulative sum graphs used to track posterior capsule rupture rates.

Related Experiment Videos

  • Competency defined as PCR rates of ≤2% (primary) and ≤5% (secondary).

    • Main Results:

    • Twenty trainees met inclusion criteria.
    • Ninety-five percent of trainees achieved a ≤5% PCR rate, requiring a mean of 106 cases.
    • Only 20% achieved a ≤2% PCR rate, with a median of 83 cases needed for the 5% threshold.

    Conclusions:

    • Significant variability exists in trainee phacoemulsification skills.
    • Achieving a low posterior capsule rupture rate demands substantial case experience.
    • At least 41 cases were needed for a 5% PCR rate, highlighting the need for extensive training.