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Training of resident ophthalmologists In cataract surgery: A comparative study of two approaches

Session Details

Session Title: Cataract 2
Session Date/Time: Saturday 21/02/2015 | 08:30-11:00
Paper Time: 09:30
Venue: Hall 1
First Author: : A.Tzamalis GREECE
Co Author(s): :    L. Lamprogiannis   N. Chalvatzis   C. Symeonidis   S. Dimitrakos   I. Tsinopoulos  

Abstract Details

Purpose:

To evaluate and compare the efficacy of two different training methods in resident-performed phacoemulsification surgery.

Setting:

2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Medical Faculty, “Papageorgiou” General Hospital, Thessaloniki, Greece

Methods:

502 eyes of 467 patients, who underwent resident-performed cataract surgery by means of phacoemulsification were included in a retrospective comparative study. Residents were allocated into two groups according to the method that was applied during their training in cataract surgery; Group 1 including residents that were trained with the 'step-by-step' method and Group 2 including residents that were trained with the 'one-step' method. The first 40 cases were additionally studied in a separate analysis. Primary outcomes were the incidence of main complications, defined as posterior capsular ruptures and zonular dehiscence with vitreous loss, and other intraoperative complications rate.

Results:

Each resident performed a median of 63 phacoemulsification surgeries (range:42-105).A statistically significant difference (p=0.0032) was noted in the main complications rate between the two groups,yielding a mean of 17.3% in Group1 and 7.25% in Group2 respectively.Other intraoperative complications,such as anterior capsule tear or extended capsulorrhexis(Group1=4.86%,Group2=4.42%),wound dehiscence(Group1=1.62%,Group2=0.95%) and corneal lesions of any kind (Group1=0.54%,Group2=0.64%) were not shown to differ statistically significantly between study groups (p>0.05).Among the first 40 surgeries of each resident, capsular tear rates differed also statistically significantly (p=0.0048) between Group1(21.67%) and Group2(12.1%),while a better surgical performance (p=0.017) was indicated in both groups in the 3rd decade of operations.

Conclusions:

Training in cataract surgery with the use of 'one-step' method may lead to an improvement in surgical competency, when measured by complication rates and phacoemulsification efficiency, and therefore, to a better quality of training for resident ophthalmologists, lowering their learning curve.

Financial Disclosure:

NONE

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