Implementation Of A Structured Surgical Curriculum Reduces Complication Rates Of Trainee Performed Cataract Surgeries

To evaluate the effect of the implementation of a structured surgical curriculum on the complication rates of trainee performed cataract surgery in a single center retrospective case series.

Hietzing Hospital, Department of Ophthalmology, Vienna, Austria

Performing a retrospective chart review of 6121 patients, who underwent cataract surgery by cataract surgeon trainees between January 2007 and December 2022 at the Department of Ophthalmology, Hietzing Hospital.

The new head of the Department of Ophthalmology implemented a structured surgical curriculum in 2009. All surgeons with experience less than 500 cataract surgeries performed were included in the new curriculum.

To evaluate the effect of the new curriculum, all complications relating to cataract surgeries since 2007 were registered and the rate of capsular rupture and re-surgeries was analyzed. The analysis considered 2-year-periods to compensate the fluctuating number of cataract surgeries performed by trainees per year.

After implementation of the structured curriculum, the capsular rupture rate decreased from 5.8% in the period 2007/2008 to 4.0% in 2009/2010. Comparing the rate of re-surgeries, a reduction from 4.3% (2007/2008) to 1.5% (2009/2010) could be achieved within the first 2 years of the new curriculum.

Continuous evaluation and improvement of the curriculum could further lower the complication rates over the next 2-year-periods to a capsular rupture rate of 1.2% and a re-surgery-rate of 0.3% in the actual time period 2021/2022.

Consistent intraoperative management, experienced attending supervision, low numbers of cataract training beginners at once, and a structured surgical curriculum lowered intraoperative complications and re-surgery rates considerably.