First Author: T.Agarwal INDIA
Co Author(s): N. Lomi R. Sharma S. Garg S. Khokhar M. Vanathi T. Dada
Purpose:
To Determine Risk Factors for
Occurrence of Intra-operative Complications during Phacoemulsification by Residents
Setting:
: RP Centre for Ophthalmic Sciences,
All India Institute of Medical Sciences,
New Delhi, India
Methods:
150 patients with cataract who underwent phacoemulsification by residents at a tertiary care centre were included in the study. The preoperative data of these patients was collected retrospectively. Surgeons were interviewed immediately after the surgery regarding the intraoperative findings. Statistical analysis was done to determine pre operative and intraoperative risk factors for occurrence of complications during resident performed phacoemulsification. Data was presented in mean, median, standard deviation, frequency and percentage. In case of continuous parameters t test / wilcoxon rank-sum test were applied. Categorical variable were analysed by using fishers exact test. Data was analysed by using STATA-11 software. P-value <0.05 was taken as significant.
Results:
Total 150 cases of phacoemulsification surgery performed by residents were included in the study. 77 males and 73 females were included in the study. Average age of patient was 61.25±10.12 yrs. No complication was seen in 63 % of cases, major complications were seen in 21% and minor complications in 16%. Posterior capsular rent was the most common major complication which constituted 74% of the major complication group. Iris prolapsed and irregular capsulorrhexis were the most common minor complications. Phacoemulsification with placement of IOL in the capsular bag without any major complications was seen in 84% of cases. Preoperative factors in term of systemic and ocular parameters had no effect on the attainment of success in resident performed phacoemusification. Increasing experience led to decrease in the rate of complication. Torsional with longitudinal phacoemulsification had no added advantage as far as success was concerned. Increased power and flow rate were significantly associated with increase rate of complications.
Conclusions:
In resident performed phacoemulsification surgery at a tertiary care centre, success outcome was 84%. With increase in semester of residents, there is a significant decrease in intra operative complications. Type of phacoemulsification (Torsional Vs Longitudinal) machine does not influence the success rate of phacoemulsification by residents. Minor complications lead to increase in major complications and decrease in success rate by junior semester residents and not so in the cases of senior semester residents. Patient factors including general physical condition, systemic diseases, anatomical factors do not influence success rate in resident performed phacoemulsification.
Financial Disclosure:
None
