ESCRS - POCAT190 - Audit Of The First 100 Independent Phacoemulsification Surgeries In Burkina Faso In A Resource-Constrained Setting

Audit Of The First 100 Independent Phacoemulsification Surgeries In Burkina Faso In A Resource-Constrained Setting

Published 2026 - 44th Congress of the ESCRS

Reference: POCAT190 | Type: Free paper | DOI: 10.82333/vrca-jr63

Authors: Dr Ahmad Nasir SAUD* 1 , Dr Qasim MANSOOR 2

1Ophthalmology,Masroor Eye Institute,Ouagadougou,Burkina Faso, 2Ophthalmology,NHS,Middlesbrough,United Kingdom

Purpose

To audit complication rates and visual outcomes from the first 100 independent phacoemulsification procedures performed by a newly trained surgeon in Burkina Faso and compare results with published early-learning benchmarks.

Setting

Masroor Eye Institute, a charitable tertiary eye centre, Burkina Faso, West Africa.

Methods

Retrospective audit of the first 100 consecutive independent phacoemulsification surgeries performed without on-site senior supervision. Prior to independent practice, the surgeon completed structured, stepwise cataract training incorporating modular progression, objective competency assessment, and human factors principles.
Data collected included demographics, preoperative visual acuity (VA), cataract density (LOCS III), intraoperative and postoperative complications, and best-corrected visual acuity (BCVA) at 1 month.
Preoperative VA ranged from Hand Movements to 6/18. Seventy-two percent had dense nuclei (LOCS III ≥3). Standard phacoemulsification with foldable IOL implantation was performed.

Results

Mean age was 63.9 ± 8.7 years. Sex ratio was 1.1.
Overall intraoperative complication rate was 16%. Posterior capsule rupture (PCR) occurred in 5%, including 2 nucleus drops. Seven cases (7%) were converted to manual small incision cataract surgery (MSICS). Anterior vitrectomy was performed in 5%, with sulcus IOL implantation where required. Descemet membrane detachment occurred in 2% and was successfully managed.
Early postoperative complications included corneal oedema (9%), raised IOP (3%), and significant inflammation (3%). No endophthalmitis occurred.
At 1 month, 85% achieved BCVA ≥6/12. The PCR rate aligns with published early-learning benchmarks (4–10%).

Conclusions

Independent phacoemulsification in a resource-limited setting is feasible with complication rates comparable to published early-career data despite advanced cataract density. Structured stepwise training using a modular competency-based model appears to support safe transition to independent practice and may be particularly valuable in low-resource surgical environments.