Posters

A multi-centre study investigating the knowledge of postoperative complications following cataract surgery amongst internal medicine and emergency medicine residents

Poster Details

First Author: C.Gunasekera UK

Co Author(s): A. Thomas                    

Abstract Details

Purpose:

Over 300,000 cataract operations are carried out each year in the United Kingdom. Postoperative complications reducing vision may include endophthalmitis, toxic anterior segment syndrome, raised intraocular pressure, intraocular lens issues, posterior capsular opacification and cystoid macular oedema. Patients suffering complications may present to emergency departments following falls from poor vision and admitted under the general medical team. Knowledge of these complications amongst frontline staff, including emergency medicine and internal medicine residents, is required for prompt ophthalmic management. This study investigates whether non-ophthalmic doctors in training are equipped with the knowledge to identify complications of cataract surgery for early referral.

Setting:

A questionnaire designed to assess the knowledge of junior doctors regarding complications of cataract surgery was distributed amongst foundation trainees, core medical trainees and emergency medicine trainees over several hospitals throughout London. A number of individual interviews were also carried out on the above cohort. Barts Health Trust is an academic department.

Methods:

The questionnaire was distributed at local and regional general medical teaching days to obtain a maximal proportion of subjects. 20 randomly selected individuals were also selected and interviewed. Questions were designed to assess background knowledge as well as possible reasons why knowledge may have been sufficient or insufficient. The answers were collected and a thematic analysis was performed to identify key patterned meaning across the dataset. These were used with the aim to develop teaching tools to improve outcomes in the future.

Results:

The main themes identified were lack of formal ophthalmology training in undergraduate and postgraduate training, a lack of knowledge of complications of cataract surgery and a desire to increase postgraduate ophthalmology training. Rarely, trainees had ever come across a patient with a complication of cataract surgery during their medical practice. Most trainees felt knowledge of management of patients presenting with complications following cataracts was relevant to their practice. There was more knowledge amongst emergency medicine trainees than general medical doctors.

Conclusions:

Knowledge regarding the complications following cataract surgery is poor amongst general medics. With an increasing aging population where the prevalence of cataracts and surgery is becoming higher, it is important that general medical doctors possess knowledge of complications that may occur following surgery and management plans. This study shows poor pre-knowledge but high motivation to learn more about cataract complications. A self-directed teaching tool in the format of a factsheet poster is being developed to address and correct this. This study would be of interest to ophthalmologists working in the hospital setting to help better educate frontline staff.

Financial Disclosure:

None