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  • Title: Outcomes of manual extracapsular versus phacoemulsification cataract extraction by beginner resident surgeons.
    Author: Meeks LA, Blomquist PH, Sullivan BR.
    Journal: J Cataract Refract Surg; 2013 Nov; 39(11):1698-701. PubMed ID: 23981512.
    Abstract:
    PURPOSE: To evaluate the safety and efficacy of phacoemulsification cataract extraction and manual extracapsular cataract extraction (ECCE) performed by beginning resident surgeons. SETTING: Dallas Veterans Affairs Medical Center, Dallas, Texas, USA. DESIGN: Retrospective cohort study. METHODS: A review was performed of each resident's series of initial cataract surgery procedures as a late first-year or second-year resident. Data were collected for cases performed over almost a 6-year period during which initially the first primary surgeon cases were ECCE and later, the first primary surgeon cases were phacoemulsification. For each case, the following data were gathered: technique of cataract extraction, laterality, resident, vitreous loss or dropped nucleus, placement of posterior chamber intraocular lens (IOL), and need for reoperation within 90 days of surgery. RESULTS: Complications occurred in 6 (2.5%) of 244 cases in which phacoemulsification was performed by a beginner resident primary surgeon and in 7 (4.1%) of 172 cases in which ECCE was used (P=.40). Posterior chamber IOLs were placed in all but 2 phacoemulsification cases and 4 ECCE cases (P=.24). Moreover, 3 cases in the phacoemulsification group and 1 case in the ECCE group required a reoperation within 90 days (P=.65). CONCLUSION: Phacoemulsification cataract extraction can be taught safely and effectively to residents with no cataract surgery experience as a primary surgeon.
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