Effect of full-time vs volunteer faculty supervision on resident cataract surgery complications
Murtaza Saifee1, Ivy Zhu, Ying Lin
1From the Department of Ophthalmology (Saifee, Zhu, Ramanathan), F. I. Proctor Foundation (Lin, Oldenburg), University of California San Francisco, San Francisco, California, and Department of Ophthalmology and Visual Sciences (Zhu), Illinois Eye and Ear Infirmary, University of Illinois, Chicago, Illinois, USA. Corresponding author: Saras Ramanathan, MD, Department of Ophthalmology, University of California, San Francisco, 10 Koret Way, K304, San Francisco, CA 94143, USA.
Purpose:
To examine the effect of teaching experience of supervising surgeons on resident cataract surgery intraoperative complication rates.
Setting:
Zuckerberg San Francisco General Hospital, University of California San Francisco, USA.
Design:
Retrospective chart review.
Methods:
Cataract surgeries performed by University of California San Francisco (UCSF) ophthalmology residents from 2010 to 2017 were reviewed. Only cases supervised by anterior segment attendings with more than 10 years of postresidency surgical experience were included. Cases were categorized as being supervised by either full-time UCSF teaching attendings or volunteer private practice attendings. Cases were graded as low risk (0 risk factors), intermediate risk (1 risk factor), or high risk (≥2 risk factors) based on 8 preoperative and intraoperative risk factors. Complication rates were compared between the 2 attending groups among varying risk grades.
Results:
Of 1377 cases, 101 developed complications. Among low-risk cases, full-time teaching attendings (25/619 [4.04%]) had a similar complication rate to volunteer attendings (17/387 [4.39%]) (odds ratio [OR] 0.92; P = .79). In intermediate-risk cases, full-time teaching attendings (28/195 [14.36%]) had slightly worse complication rates than volunteer attendings (10/88 [11.36%]) (OR 1.63; P = .45). High-risk cases had the highest complication rates, with the complication rates of full-time teaching attendings (16/72 [22.22%]) somewhat lower than those of volunteer attendings (5/16 [31.25%]) (OR 0.64; P = .48).
Conclusions:
For low-risk resident-performed cataract surgeries, supervision by full-time faculty and volunteer attendings yielded similar complication rates; thus, residency programs might safely recruit volunteer attendings to supervise low-risk cataract surgeries to support resident training. The analysis of higher-risk cases was limited by a low surgical volume.
