A Microsurgical Skills Course Improves Cataract Surgery Proficiency in First Year Australia and New Zealand Ophthalmology Trainees.

BACKGROUND

The University of Sydney 'Microsurgical Skills Course' (MSC) was made mandatory to the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) Vocational Training Program in 2023. This study evaluates the MSC impact on first-year ophthalmology trainees' cataract surgical performance compared to those who did not complete the MSC.

METHODS

This retrospective study analysed de-identified RANZCO surgical logbook data and EyeSi survey responses from first-year trainees across Australia and New Zealand. The intervention cohort (2023-2024 first-year trainees) completed the MSC, while the control cohort (2022 first-year trainees) did not. Data included demographics, prior surgical experience, number of cataract surgeries, surgical role, senior surgeon takeovers and intraoperative complications.

RESULTS

Among 112 trainees (intervention = 77; control = 35), 11 613 cataract surgeries were recorded during the first 12 months of training. By 3 months, trainees in the intervention cohort performed more cataract surgeries (36.2 ± 22.6 vs. 26.0 ± 17.4, p = 0.017), assumed more senior roles in surgery (p < 0.001), required fewer senior surgeon takeovers (p < 0.001) and had a lower rate of posterior capsule tear (PCT) (1.3% vs. 2.9%, p < 0.001) compared to the control cohort. By 12 months, cataract surgery numbers and PCT rates (1.4% vs. 1.8%; p = 0.186) were similar; however, the intervention cohort still held a higher rate of leading surgical roles (p < 0.001) and less senior surgeon takeover (p < 0.001).

CONCLUSIONS

The MSC accelerates early surgical proficiency while improving patient safety. This resource will serve as a foundation for assessing surgical outcomes beyond cataract surgery and extending past the first 12 months of training.