Incidence and Risk Factors for Intraoperative Complications in Resident-performed Phacoemulsification Surgery.

Area of Science:

• Ophthalmology
• Surgical Education
• Patient Safety

Background:

• Phacoemulsification is a common cataract surgery technique.
• Training centers aim to optimize resident surgical skills while ensuring patient safety.
• Intraoperative complications can impact surgical outcomes and patient recovery.

Purpose of the Study:

• To determine the incidence of intraoperative complications during phacoemulsification by ophthalmology residents.
• To identify risk factors associated with these complications in a training setting.

Main Methods:

• A comparative case series of 1121 eyes undergoing phacoemulsification by residents.
• Retrospective review of medical records for patient demographics, comorbidities, and surgical details.
• Multivariate analysis to identify independent risk factors for intraoperative complications.

Main Results:

• The overall intraoperative complication rate was 5.6% (63/1121 eyes).
• Posterior capsular rupture with vitreous loss (2.6%) and anterior capsular tear (1.9%) were most frequent.
• Mature/brunescent cataracts and less resident experience (training year) were independent risk factors for vitreous loss.

Conclusions:

• Mature or brunescent cataracts and less experienced residents are associated with increased intraoperative complications.
• Careful case selection and direct attending supervision are vital for mitigating risks in resident-led surgeries.
• These findings underscore the importance of structured training and oversight in ophthalmology residency programs.