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Assessment of Learning Curve in Phacoemulsification Surgery Among the Eastern Province Ophthalmology Program Residents

Authors Al-Jindan M, Almarshood A, Yassin SA, Alarfaj K, Al Mahmood A, Sulaimani NM

Received 5 December 2019

Accepted for publication 27 December 2019

Published 14 January 2020 Volume 2020:14 Pages 113—118

DOI https://doi.org/10.2147/OPTH.S241250

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Mohanna Al-Jindan, 1 Abdullah Almarshood, 2 Sanaa A Yassin, 1 Khalid Alarfaj, 1 Ammar Al Mahmood, 3 Naif M Sulaimani 3

1Department of Ophthalmology, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2Department of Ophthalmology, Qassim University, Qassim, Saudi Arabia; 3Dhahran Eye Specialist Hospital, Al-Dhahran 31942, Saudi Arabia

Correspondence: Sanaa A Yassin
Department of Ophthalmology, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
Email syassin@iau.edu.sa

Purpose: To assess residents’ performance of phacoemulsification surgery and determine which steps of the procedure are most difficult to learn, and to measure rate of intraoperative complications.
Design: This was a prospective observational study.
Methods: Phacoemulsification surgery was divided into steps and each step was given a proficiency grade by the attending consultant. All intraoperative complications were recorded and analyzed.
Results: 200 cases performed by the Eastern Province ophthalmology program residents were evaluated. The most commonly encountered difficulty factors were hard nucleus (20.7%), small pupil (12.6%), and white cataract (10.3%). Capsulorhexis, nucleus disassembly and removal, and cortex removal were the most difficult steps to learn. General complication rate was 17.5%, and posterior capsular rupture was the most common complication (40%). Proficiency more than 90% of the time in each step was noted in residents with prior experience of more than 40 cases, except for nucleus disassembly.
Conclusion: The study showed that nucleus disassembly remained the major obstacle in the residents’ exponential learning curve of phacoemulsification surgery. Majority of complications occurred at level of capsulorhexis and cortical removal steps.

Keywords: phacoemulsification, learning curve, residents, training, complication rate


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