Phacoemulsification during the learning curve: risk/benefit analysis

To assess prospectively the complications and outcomes in a single-surgeon series during the phacoemulsification learning curve a prospective analysis of 400 phacoemulsification procedures in 358 patients was carried out. The main outcome measures were capsular tear, vitreous and nuclear loss, best corrected post-operative visual acuity and refractive cylinder. Capsular tears occurred in 6.3% of phacoemulsification procedures, with vitreous loss in 1.5%. One nucleus was lost into the vitreous. Best corrected visual acuity, including pre-existing pathology, was 6/9 or better in 83.6% of eyes. There was 1 dioptre or less change of astigmatism from pre-operative to 6 weeks in 91% of eyes. It is concluded that phacoemulsification with careful patient selection can be a safe procedure even during the learning curve.