Step-by-step phacoemulsification training program for ophthalmology residents.
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Date
2013-11
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Abstract
Aims: The aim was to analyze the learning curve of phacoemulsification (phaco) performed by residents
without experience in performing extra‑capsular cataract extraction (ECCE) in a step‑by‑step training
program (SBSTP). Materials and Methods: Consecutive surgical records of phaco performed from March
2009 to Sept 2011 by four residents without previous ECCE experience were retrospectively reviewed.
The completion rate of the first 30 procedures by each resident was calculated. The main intraoperative
phaco parameter records for the first 30 surgeries by each resident were compared with those for their last
30 surgeries. Intraoperative complications in the residents’ procedures were also recorded and analyzed.
Results: A total of 1013 surgeries were performed by residents. The completion rate for the first 30 phaco
procedures was 79.2 ± 5.8%. The main reasons for halting the procedure were as follows: Anterior capsule
tear, inability to crack the nucleus, and posterior capsular rupture during phaco or cortex removal.
Cumulative dissipated energy of phaco power used during the surgeries was significantly less in the last
30 cases compared with the first 30 cases (30.10 ± 17.58 vs. 55.41 ± 37.59, P = 0.021). Posterior capsular
rupture rate was 2.5 ± 1.2% in total (10.8 ± 4.2% in the first 30 cases and 1.7 ± 1.9% in the last 30 cases,
P = 0.008; a statistically significant difference). Conclusion: The step‑by‑step training program might be
a necessary process for a resident to transit from dependence to a self‑supported operator. It is also an
essential middle step between wet lab training to performing the entire phaco procedure on the patient
both effectively and safely.
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Keywords
Complication, phacoemulsifi cation learning curve, resident training
Citation
Yulan Wang, Yaohua Sheng, Jinhua Tao, Min Wang. Step-by-step phacoemulsification training program for ophthalmology residents. Indian Journal of Ophthalmology. 2013 Nov ; 61 (11): 659-662.