ePoster

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Title:

Incidence, characteristics, outcomes and confidence in managing posterior capsular rupture during cataract surgery in the UK: an ophthalmology trainees’ perspective

Poster Details

First Author: D. Ting UK

Co Author(s):    M. Grinton   J. Sandhu   A. Shwe-Tin   D. Steel           

Abstract Details

Purpose:

To examine the incidence, characteristics, and outcomes of posterior capsular rupture (PCR) cases amongst the ophthalmology trainees and to evaluate the traineesﾒ confidence in managing PCR.

Setting:

A two-staged cross-sectional study conducted in the North East of England, UK.

Methods:

This two-stage study was carried out between September 2017 and April 2018. During the first stage, a questionnaire-based survey was sent to all 21 ophthalmology trainees in the region to examine their experience in cataract surgery and confidence level in managing PCR. During the second stage, all trainees were requested to retrospectively review all the PCR cases and collect data on the pre-, intra- and post-operative characteristics and outcomes of these cases.

Results:

Fifteen (71.4%) trainees completed the study. The mean number of phacoemulsification was 268.9+/-250.9 cases (range, 0-705). There were 82 (1.9%) cases of PCR reported among 4303 phacoemulsification. PCR occurred most commonly during quadrant removal (44.0%) and cortex removal (21.3%). Best-corrected-visual-acuity (in logMAR) improved significantly from 0.47+/-0.32 preoperatively to 0.20+/-0.19 postoperatively (p<0.001). Supervising consultants took over 80.5% of PCR cases. PCR rate decreased significantly from 3.1% at 0-100 cases to 0.4% at >500 cases (p=0.005). Confidence in managing PCR improved from 0% at junior level to 50% at senior level, and the mean number of anterior vitrectomies performed was 0.6+/-0.9.

Conclusions:

We observed a low PCR rate among the trainees in our region, with the majority of cases achieving good visual outcome. This suggests that PCR may still result in good outcome even it is managed appropriately. A significant reduction in PCR rate was observed at the threshold of >500 cases. There is however a lack of confidence among trainees in managing PCR, highlighting the need for devising new training strategies in this area.

Financial Disclosure:

None