Copenhagen 2016 Registration Programme Exhibitor Information Virtual Exhibition Satellite Meetings Glaucoma Day 2016 Hotel Star Alliance
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10 - 14 Sept. 2016, Bella Center, Copenhagen, Denmark

This Meeting has been awarded 27 CME credits

 

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Endothelial cell loss, central corneal thickness and ultrasound features after cataract surgery with phacoemulsification, depending on experience level in a training hospital

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Session Details

Session Title: Presented Poster Session: Training and Innovation in Education/Quality of Vision Evaluation

Session Date/Time: Monday 12/09/2016 | 09:30-11:00

Paper Time: 10:20

Venue: Poster Village: Pod 3

First Author: : M.Cadena-Torres MEXICO

Co Author(s): :    R. Villasenor-Garci­a   S. Peniche-Moreno   L. Fernandez-de-Ortega   K. Perez-Bailon     

Abstract Details

Purpose:

To determine succes in cataract surgery with phacoemulsification according to training level, considerating final cumulative dissipated energy (CDE) and elapsed phaco time (EPT), as well as postsurgical corneal endothelial cell loss percentage and central corneal thickness in a training hospital.

Setting:

Objective factors must be considered on surgery training to measure progress. Endothelial integrity can result deeply affected as an adverse effect in this type of surgery. An estimated 9-12% of endothelial cells loss could be expected in experienced surgeons, but there is no such information according to residence year.

Methods:

This is a longitudinal, prospective, comparative, aleatorized, interventional study. 35 eyes were included and had cataract surgery with phacoemulsification and intraocular lens implant using Alcon Infinity Vision System with Ozil and stop and chop technique. Three groups were aleatorized; second (10/35) and thrid (12/35) year residents and anterior segment fellow (13/35). Specular microscopy and ultrasound pachimetry were documented pre and postsurgically at days 1, 7 and 30. CDE and EPT were also registered. Exclusion criteria included precedent ipsilateral ocular surgery, preexisting corneal pathology, LOCS III N4 or worse cataract, presence of diabetic retinopathy, shallow anterior chamber and pseudoexfoliation syndrome.

Results:

Mean age was 68.91 years. Mean basal endotelial cell density was 2258 cells/mm3; postsurgically for each group: 2224, 2403 and 2190 (p 0.61). Mean endotelial cell loss after one month was 12.57%, 27.87% and 13.78%. Mean central corneal thickness was 561 μm and 603.3, 646.3 and 605.1μm on the first day after surgery (p 0.1478). Mean used CDE was 11.67, 6.94 and 6.01 for each group; a statistically significant difference was found only between second year residents and fellows groups in a post hoc analysis (p 0.017). Mean EPT was 19.93s, 22.61s and 15.16s, respectively (p 0.50).

Conclusions:

A statistically significant difference in CDE used by first versus third group was found. This could be the result of a more efficient ultrasound utilization by more experienced surgeons. We expected to find a higher endothelial cell loss with less time of experience, but supervision of every surgery step is closer during the first years of training. However, there wasn’t a significant difference for it in this study. In surgical training, objetive measurements of progress are outstanding and can lead to a more personalized instruction, resulting in better outcomes. Further studies are necessary to validate and expand these findings.

Financial Disclosure:

NONE

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