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Conversion to coaxial micro incision phacoemulsification cataract surgery: trainee’s perspective

Session Details

Session Title: Surgical Outcomes

Session Date/Time: Monday 07/10/2013 | 08:00-09:30

Paper Time: 09:18

Venue: Auditorium (First Floor)

First Author: : M.Rajan UK

Co Author(s): :                  

Abstract Details

Purpose:

To evaluate surgical complications and learning curve amongst ophthalmic trainees undergoing transition from conventional to micro incision cataract surgery

Setting:

Cambridge University teaching hospitals NHS Trust, Cambridge, United Kingdom

Methods:

A consecutive series of 779 coaxial 2.2 mm micro incision cataract surgery (C-MICS) performed using the Stellaris MICS platform (Bausch and Lomb) and Akreos MI60 intraocular lens were assessed for intraoperative complications and final visual outcome. A 8 point questionnaire survey was completed by ophthalmic surgical trainees to describe learning curve including surgical complications.

Results:

A total of 779 C-MICS procedures included 249 eyes (32 %) with ocular co-morbidities. In eyes with no ocular co-morbidities the rate of posterior capsule breach with vitreous loss (PCR/VL) was 0.3% compared to 2.4% in eyes with ocular co-morbidities. The final best corrected Snellen’s acuity of 6/9 or better was achieved in 412 (92%) eyes with no ocular co-morbidities compared to 146 eyes (74%) in eyes with visual co-morbidities. The rate of PCR for ophthalmic trainees was 1.9 % in this series and was found to decrease significantly following their first 20 cases. Surgical steps during transition to C-MICS with increasing complexity as rated by the trainees included forceps assisted capsulorhexis through 2.2 mm incision, wound assisted IOL insertion and wound closure. All these surgical steps were adopted with ease and rated as not difficult following the learning curve. Intraoperative anterior chamber stability was returned as the single most advantage in C-MICS compared to conventional phacoemulsification surgery.

Conclusions:

The transition to C-MICS from conventional phacoemulsification cataract surgery incorporated in ophthalmic surgical training does not compromise visual outcomes and has an added advantage in decreasing intraoperative complications in eyes with ocular co-morbidities such as high myopia, eyes with shallow anterior chamber, small pupils and floppy iris syndrome.

Financial Interest:

... travel has been funded, fully or partially, by a company producing, developing or supplying the product or procedure presented