Vivek M Singh1, Revathy Yerramneni1, Tanvi Madia1, Sai Prashanthi2, Pravin K Vaddavalli1,2, Jagadesh C Reddy3,4,5. 1. Cataract & Refractive Surgery Services, L V Prasad Eye Institute, Hyderabad, India. 2. Cornea Institute, L V Prasad Eye Institute, Hyderabad, India. 3. Cataract & Refractive Surgery Services, L V Prasad Eye Institute, Hyderabad, India. jagadeshreddy@lvpei.org. 4. Cornea Institute, L V Prasad Eye Institute, Hyderabad, India. jagadeshreddy@lvpei.org. 5. Department of eyeSmart EMR & AEye, L V Prasad Eye Institute, Hyderabad, India. jagadeshreddy@lvpei.org.
Abstract
PURPOSE: To compare outcomes of cataract surgery performed by ophthalmic trainees and consultants in patients associated with pseudoexfoliation (PXF) METHODS: Retrospective review of medical records of all patients with PXF who had undergone cataract surgery from January 2016 to December 2018 at L V Prasad Eye Institute, Hyderabad, India, were analysed RESULTS: A total of 914 eyes were included in the study; surgeries on 501 (54.8%) eyes with PXF were performed by trainees, while 413 (45.2%) were performed by consultants. Posterior capsule rupture (PCR) with vitreous loss (VL) occurred in significantly fewer eyes operated on by consultants (n = 8, 1.9%) than those operated on by trainees (n = 23, 4.5%) (p = 0.002). Eyes that underwent small incision cataract surgery (n = 100, 21.2%) had a significantly greater number of complications than those that underwent phacoemulsification (n = 31, 7.1%) (p = 0.00001). Multivariate logistic regression analysis shows that chances of a complication are higher when operated on by a trainee (OR = 1.59, 95% CI: 1.09-2.34, p = 0.02).The mean logMAR corrected distance visual acuity of patients one month post-surgery was significantly higher for patients in the consultant group (0.15 ± 0.3) than for those in the trainee group (0.2 ± 0.4) (p = 0.003). CONCLUSION: Patients with PXF operated on by trainees for cataract had a relatively higher risk of developing PCR with VL and had poorer visual outcomes than those operated on by consultants.
PURPOSE: To compare outcomes of cataract surgery performed by ophthalmic trainees and consultants in patients associated with pseudoexfoliation (PXF) METHODS: Retrospective review of medical records of all patients with PXF who had undergone cataract surgery from January 2016 to December 2018 at L V Prasad Eye Institute, Hyderabad, India, were analysed RESULTS: A total of 914 eyes were included in the study; surgeries on 501 (54.8%) eyes with PXF were performed by trainees, while 413 (45.2%) were performed by consultants. Posterior capsule rupture (PCR) with vitreous loss (VL) occurred in significantly fewer eyes operated on by consultants (n = 8, 1.9%) than those operated on by trainees (n = 23, 4.5%) (p = 0.002). Eyes that underwent small incision cataract surgery (n = 100, 21.2%) had a significantly greater number of complications than those that underwent phacoemulsification (n = 31, 7.1%) (p = 0.00001). Multivariate logistic regression analysis shows that chances of a complication are higher when operated on by a trainee (OR = 1.59, 95% CI: 1.09-2.34, p = 0.02).The mean logMAR corrected distance visual acuity of patients one month post-surgery was significantly higher for patients in the consultant group (0.15 ± 0.3) than for those in the trainee group (0.2 ± 0.4) (p = 0.003). CONCLUSION:Patients with PXF operated on by trainees for cataract had a relatively higher risk of developing PCR with VL and had poorer visual outcomes than those operated on by consultants.
Authors: H Arvind; P Raju; P G Paul; M Baskaran; S Ve Ramesh; R J George; C McCarty; L Vijaya Journal: Br J Ophthalmol Date: 2003-11 Impact factor: 4.638