Assessment of perceived difficulties by residents in performing routine steps in phacoemulsification surgery and in managing complications.

OBJECTIVE

To analyze the perceived difficulties of residents in performing the routine steps of phacoemulsification surgery and in managing complications.

DESIGN

Cross-sectional questionnaire-based study.

PARTICIPANTS

Thirty-six residents performing phacoemulsification during their learning curve.

METHODS

On an 8-point Likert scale, residents noted comfort levels with various steps of cataract surgery and with managing complications.

RESULTS

The respondents were grouped into Group 1 (second-year residents, n = 19) and Group 2 (third-year residents, n = 17). Residents in Group 2 had greater surgical experience than residents in Group 1 (p = 0.001). The most difficult step in cases of phacoemulsification for Group 1 was loading a foldable intraocular lens (IOL) (mean score 6.05, SD 1.57), and for Group 2 it was nuclear emulsification (mean score 3.59, SD 1.42). Both second- and third-year residents found capsular bag dialysis the most difficult complication (mean scores 6.0 [SD 1.9] and 5.75 [SD 2.14], respectively). The second-year residents had significantly more difficulty with errant capsulorrhexis, anterior chamber IOL placement, and repeated iris prolapse as compared with third-year residents. Group 2 residents reported that mature, senile cataracts were the most difficult cases for them to manage (mean score 6.23, SD 1.56).

CONCLUSIONS

This study identifies perceived difficulties that residents experience in routine cases of cataract surgery, highlighting specific areas in which they may benefit from additional training and practice.