A review of a registry of 14,520 cataract surgeries performed at the Ophthalmology Unit of Kymenlaakso Central Hospital in Kotka, Finland, between August 8, 2009, and July 31, 2017, reported capsular bag–related complications in 0.36% of surgeries performed by senior surgeons compared with 7.03% performed by resident surgeons (Aaronson et al., 2020).
Similarly, a study evaluating cataract surgery outcomes among residents at different levels of experience found that complication rates decreased progressively throughout training — from 23.53% during the first semester to 20.93% during the second semester and 11.31% during the third semester. The authors also noted that complication rates tend to decline after residents gain experience with approximately 70 cataract procedures. In this program surgical training follows a stepwise approach. Cataract surgery is introduced during the second year of the three-year residency, beginning with extracapsular cataract extraction (ECCE), followed by progressively advanced training in phacoemulsification (Melega et al., 2020).
I would be interested to hear from colleagues on the forum:
What are the baseline or typical complication rates observed among ophthalmology residents during cataract surgery training in your country or institution?
Which cataract procedure do you typically introduce first — ECCE, manual small-incision cataract surgery (MSICS), or phacoemulsification?
Approximately how many cataract surgeries of each type do residents perform during their residency?
Is there a defined minimum number of procedures or competency threshold that residents are expected to achieve before graduating to more advanced techniques?
Have you used simulation-based training and if yes, how have you integrated it in your curriculum?
References
1, Aaronson A, Viljanen A, Kanclerz P, Grzybowski A, Tuuminen R. Cataract complications study: an analysis of adverse effects among 14,520 eyes in relation to surgical experience. Ann Transl Med. 2020;8(22):1541. doi:10.21037/atm-20-845.
2. Melega MV, Pessoa Cavalcanti Lira R, da Silva IC, et al. Comparing resident outcomes in cataract surgery at different levels of experience. Clin Ophthalmol. 2020;14:4523-4531. doi:10.2147/OPTH.S285967.
Dr. Hinaben Patel (Ph.D.)
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HIFA profile: Hinaben Patel is Director, Grants and Development at HelpMeSee, United States. Professional interests: Ophthalmology education, Epidemiology, Public Healthcare, Eye health education, epidemiology, public health, and research and innovation. hinaben AT helpmesee.org