Perceived Difficulty Of Cataract Surgery Steps, Surgical Stress, And Complication Management Confidence During Ophthalmology Residency

To evaluate the perceived difficulty of individual cataract surgery steps among ophthalmology residents and to explore how these perceptions change with training level. The study also aims to assess surgical stress and residents’ confidence in managing intraoperative complications, and to compare these parameters between junior and senior residents in order to better understand the learning curve in cataract surgery training.

This cross-sectional survey study was conducted among ophthalmology residents through an anonymous online questionnaire distributed via professional communication networks and messaging platforms.

A cross-sectional survey was conducted among ophthalmology residents using an anonymous online questionnaire. Participants reported their training year (0–1, 1–2, 2–3, and 3–4 years) and were subsequently categorized into junior (0–3 years) and senior (3–4 years) groups for analysis. The questionnaire assessed perceived difficulty across different steps of cataract surgery, surgical stress, and confidence in managing intraoperative complications using Likert-scale responses. Group comparisons were performed to evaluate differences related to training level and surgical experience.

A total of 50 ophthalmology residents participated (26 junior, 24 senior). Junior residents reported significantly greater difficulty in capsulorhexis and nucleus manipulation compared with senior residents (p<0.01). Senior residents demonstrated significantly higher confidence in managing intraoperative complications, including posterior capsule rupture, vitreous loss, zonular dialysis, and nucleus drop (p<0.01). Junior residents also reported more intraoperative hand tremor (p<0.01), while perceived supervisor pressure tended to be higher among senior residents. Within-group analysis showed significant variation across surgical steps, with phaco machine parameter adjustment remaining the most challenging step for senior residents.

Perceived difficulty in cataract surgery varies across training stages. Junior residents experience greater technical difficulty, particularly in capsulorhexis and nucleus management, whereas senior residents show higher confidence in managing intraoperative complications. Surgical stress and hand tremor appear more pronounced in earlier training years. Despite overall improvement with experience, understanding phaco machine parameters remains challenging even for senior residents. These findings highlight key areas in cataract surgery training that may benefit from targeted educational support.