Learning Curve Differences in a Novice Cataract Surgeon: Comparing Femtosecond Laser-assisted and Conventional...

Area of Science:

• Ophthalmology
• Surgical Technology
• Medical Education

Background:

• Cataract surgery is a common procedure with evolving techniques.
• Novice surgeons face a learning curve in mastering surgical efficiency.
• Comparing femtosecond laser-assisted cataract surgery (FLACS) with conventional phacoemulsification cataract surgery (CPCS) is crucial for understanding skill acquisition.

Purpose of the Study:

• To evaluate the learning curve for operating time (OT) and effective phacoemulsification time (EPT) in cataract surgery.
• To compare the development of OT and EPT between FLACS and conventional phacoemulsification cataract surgery (CPCS) in novice surgeons.
• To conduct subgroup analyses based on nucleus cataract grading and surgical experience.

Main Methods:

• Retrospective analysis of 426 cataract surgeries (95 FLACS, 331 CPCS).
• Cohorts divided into four chronological quartiles to assess learning curves.
• Outcomes analyzed by nucleus cataract grades (0-3 and 9), with OT and EPT as primary endpoints.

Main Results:

• Both FLACS and CPCS showed significant improvements in OT and EPT over time.
• Median OT decreased from 23 to 15 min (FLACS) and 26 to 15 min (CPCS) across quartiles.
• Median EPT decreased from 2.2 to 0.6 s (FLACS) and 7.0 to 1.6 s (CPCS) across quartiles.
• FLACS maintained lower EPT, especially in early cases, potentially reducing ocular stress.

Conclusions:

• Both FLACS and CPCS demonstrate a clear learning curve with increasing surgeon experience.
• FLACS may offer benefits in reducing effective phacoemulsification time and ocular stress during initial surgical training.
• Comparable learning curves were observed despite fewer FLACS cases, likely due to overlapping training periods.