Outcomes of resident-performed small incision cataract surgery in a university-based practice in the USA
Received 19 December 2018
Accepted for publication 4 February 2019
Published 20 March 2019 Volume 2019:13 Pages 529—534
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 3
Editor who approved publication: Dr Scott Fraser
Sidra Zafar, Xinyi Chen, Shameema Sikder, Divya Srikumaran, Fasika A Woreta
Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD, USA
Purpose: To assess outcomes of resident-performed small incision cataract surgery (SICS) at a single academic institute and to determine the availability of SICS-oriented educational resources in residency programs across the USA.
Patients and methods: A retrospective chart review was conducted on all patients who underwent SICS performed by postgraduate year 4 residents between January 2014 and January 2018 at the Wilmer Eye Institute, Baltimore, MD, USA. Postoperative visual acuity, intraoperative complications, and postoperative complications were the main outcomes measured. In addition, a survey was administered to all ophthalmology residency program directors in the USA to assess the presence of SICS-related content in their surgical training curriculum.
Results: Twenty-two eyes of 17 patients underwent planned resident-performed SICS, mainly for white cataracts. Intraoperative complications occurred in two (9.1%) eyes. The most common postoperative complication was transient increased intraocular pressure (two eyes, 9.1%). Mean preoperative best-corrected visual acuity (BCVA) was approximately 20/4,000. The large majority (95.2%) of eyes experienced improved BCVA following SICS, with a mean postoperative BCVA of 20/138 over an average follow-up of 4.2 months. Forty-seven programs responded to the survey (40.1% response rate). Residents were trained in SICS in 66.7% of these programs. However, more than half of all the programs did not have SICS-oriented educational resources available for residents.
Conclusion: Resident-performed SICS was found to be a safe and effective technique for cataract management. Considering the limited surgical volume for SICS in the USA, training programs might instead consider implementing SICS-oriented content in their surgical curriculum, including wet labs.
Keywords: resident, cataract, mature, SICS, surgical training
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