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Phacoemulsification learning curve: experience of two junior trainee ophthalmologists
1Royal Eye Infirmary, Dorset County Hospital, England.
Purpose:
To establish the incidence of complications during surgery performed by junior trainees learning phacoemulsification.
Setting:
Eye infirmary in a United Kingdom district general hospital.
Methods:
A retrospective review of case notes of the first 102 cases of phacoemulsification procedures performed by two senior house officers was done. Main outcome measures were change in surgical plan, position of implanted lens, posterior capsule tear, vitreous loss, zonule loss, and visual outcome at discharge. Follow-up was 6 weeks.
Results:
A posterior capsule tear occurred in 6 eyes (5.8%) and vitreous loss in 3 (2.9%). All eyes had a posterior chamber lens, 6 (5.8%) implanted in the sulcus and 96 (94.2%), in the capsular bag. Eleven eyes (10.8%) had a visual acuity of 6/18 or worse at discharge: of these, 10 had pre-existing pathology in keeping with the level of acuity. In the other eye, there was no apparent cause for the 6/18 acuity.
Conclusions:
The study indicates that junior trainees can be taught phacoemulsification with acceptable complication rates and visual results. The results compare favorably with reports of senior surgeons converting to phacoemulsification, trainee surgeons learning extracapsular surgery, and recently reported phacoemulsification series.
