Advanced cataract learning experience in United States ophthalmology residency programs

Area of Science:

• Ophthalmology
• Medical Education
• Surgical Training

Background:

• Cataract surgery techniques are rapidly evolving.
• Ensuring resident competency in new procedures is crucial for patient care.
• Advanced technologies like toric IOLs and femtosecond lasers are increasingly adopted.

Purpose of the Study:

• To assess ophthalmology resident exposure and competency in new cataract removal and intraocular lens (IOL) implantation techniques.
• To identify the primary teaching methods for advanced cataract surgery technologies in US residency programs.

Main Methods:

• A questionnaire was distributed to 116 United States ophthalmology program directors.
• 71 program directors completed the questionnaire, providing data on resident training and competency.
• Data analysis focused on reported competency levels and exposure to specific surgical techniques and technologies.

Main Results:

• 95.3% of graduating residents were competent in toric IOLs, while 52.3% were competent in capsular tension rings (CTRs).
• Divide and conquer (56.6%) and stop and chop (25.4%) were dominant phacoemulsification methods taught.
• Resident exposure to femtosecond laser-assisted cataract surgery varied: 44.1% performed it, 25.4% observed, 35.6% had didactic-only training, and 22.0% had no exposure.
• Wet-lab practice (91.1%), didactic training (82.1%), and videos (82.1%) were primary teaching tools, despite 73.2% of programs having virtual-reality simulators.

Conclusions:

• Ophthalmology residents demonstrate high competency in toric IOL implantation but less so in CTRs.
• Training in advanced cataract surgery techniques like femtosecond laser surgery is inconsistent across programs.
• Traditional methods like wet-lab practice and didactic sessions are heavily relied upon for teaching new technologies.