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Retrospective outcome analysis of manual SICS during different phases of training of ophthalmology trainees as compared to the consultants

Poster Details

First Author: K.Shahare INDIA

Co Author(s):    H. Vannadil   M. Khan                 

Abstract Details


To assess the level of training of residents during different phases of the learning curve of manual small incision cataract surgery (MSICS) by comparing the visual outcomes and complications with that of the consultants.


This is a retrospective cohort study conducted at Armed Forces Medical College, Pune, India from 1 January 2016 to 31 December 2016.


All consecutive cases of age related cataract grade NSII or more without any other ocular co-morbidity were included. A retrospective chart review was carried out of all patients undergoing MSICS performed by consultants and residents in different phases of training. The residents did MSICS only after mandatory hours of training in skills lab, adequate observation of surgeries and stepwise training. Careful monitoring of trainee surgeries was done by consultants through display on TV monitor. The visual acuity before and after the surgery and complications in MSICS done by second and third year trainees and consultants were analysed.


The study included 61 eyes in each group. As expected, the mean postoperative best-corrected visual acuity (BCVA) was significantly better in consultant group (0.33�Â�±0.41 log MAR) than trainee group (0.46�Â�±0.34 logMAR, p < 0.001). However, the difference was narrower when third year trainees (0.37 Log MAR) were separately compared with second year (0.77 Log MAR) indicating significant improvement with training. Less complication rate was seen in consultant group(18.03%) as compared to trainees(48.33%). However, pattern of complications was similar in both the groups with most common minor complication being striate keratopathy and most common major complication being posterior capsular rent.


Comparison of visual outcomes and complication rates can serve as a method of assessing the efficacy of training and the training programme. Stepwise-supervised training can minimize the complications and achieve good outcomes even in the hands of trainees.

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