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Ifantides C, SooHoo JR, Christopher KL. Impact of a formal manual small-incision cataract surgery curriculum in an American ophthalmology residency program. Indian J Ophthalmol 2023; 71:2474-2477. [PMID: 37322664 PMCID: PMC10417980 DOI: 10.4103/ijo.ijo_1339_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/02/2022] [Accepted: 10/20/2022] [Indexed: 06/17/2023] Open
Abstract
Purpose Global ophthalmology educational activities often include the ability of ophthalmology residents to partake in low-resource clinical care at home and abroad. Low-resource surgical techniques have become a pillar of education during formalized global ophthalmology fellowships. A formal manual small-incision cataract surgery (MSICS) curriculum was started in the University of Colorado's residency training program to meet the growing demand for this surgical skill and to allow for more sustainable outreach work from our graduates. The survey was conducted to collect evaluations on the value of formal MSICS training within a United States-based residency program. Methods This was a survey study in a US ophthalmology residency program. A formal MSICS curriculum was created that included didactic lectures on epidemiology of global blindness, MSICS technique, and how MISCS compared to phacoemulsification in terms of cost and sustainability in low-resource settings, followed by a formal wet lab experience. Residents were then exposed to MSICS procedures in the operating room (OR) under supervision of an experienced MSICS surgeon. An anonymous online survey was conducted on three consecutive cohorts of recently graduated senior ophthalmology residents from 2019 to 2021 with the aim of eliciting opinions about and outcomes from the new curriculum. Results Fifteen graduating senior residents comprised the three cohorts with a 100% survey response rate. All residents agreed or strongly agreed that "MSICS is a valuable skill to have". Eighty percent of respondents agreed or strongly agreed that "exposure to MSICS has increased my likelihood of doing any type of outreach work in the future" and 86.67% agreed or strongly agreed that "exposure to MSICS increased my understanding about sustainable outreach work". The average number of cases assisted or performed per resident was 8.2 (SD 2.7, range 4-12). Conclusion A formal MSICS curriculum for US-based ophthalmology residents was well-received by the trainees. The majority felt it increased their likelihood of pursuing and improved their understanding of sustainable outreach work. The curriculum, which included lectures, wet lab training, and formal teaching in the OR, could add value to a residency program's curriculum. Furthermore, a formal domestic program can avoid ethical pitfalls that can be seen with resident teaching during international mission work.
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Affiliation(s)
- Cristos Ifantides
- Department of Surgery, Denver Health Medical Center, Denver, CO, USA
| | - Jeffrey R SooHoo
- Department of Ophthalmology, University of Colorado, Aurora, CO, USA
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Bejjenki P, Gurnani B, Kaur K, Tejaswini A, Sinha A, Venkatesh D, Morya AK. Commentary: Impact of manual small-incision cataract surgery on outreach and training curriculum across the world. Indian J Ophthalmol 2023; 71:2478-2479. [PMID: 37322665 PMCID: PMC10417978 DOI: 10.4103/ijo.ijo_2230_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Affiliation(s)
- Priyanka Bejjenki
- Department of Ophthalmology, All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | - Bharat Gurnani
- Consultant Cataract, Cornea, External Disease, Trauma, Ocular Surface and Refractive Surgery, Amritsar, Punjab, India
| | - Kirandeep Kaur
- Consultant Cataract, Pediatric Ophthalmology and Strabismus, Dr. Om Parkash Eye Institute, Amritsar, Punjab, India
| | - Antarvedi Tejaswini
- Department of Ophthalmology, All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | - Aprajita Sinha
- Specialty Doctor in Ophthalmology, Worcestershire Acute Hospitals NHS Trust, Worcester, United Kindgom
| | - Dharavath Venkatesh
- Department of Ophthalmology, All India Institute of Medical Sciences, Bibinagar, Telangana, India
| | - Arvind K Morya
- Department of Ophthalmology, Cataract, Glaucoma, Refractive, Squint, Pediatric Ophthalmology and Medical Retina Services, All India Institute of Medical Sciences, Bibinagar, Telangana, India
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Bhullar PK, Venkateswaran N. Ophthalmology Residency in the United States: The Case for a National Curriculum. Semin Ophthalmol 2023; 38:167-177. [PMID: 36653736 DOI: 10.1080/08820538.2022.2152713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
To identify strategies for effective curriculum development and implementation in United States (US) ophthalmology residency training programs. A literature review was conducted for all English-language PubMed/Medline articles relating to ophthalmology residency education or curriculum/curricula. Despite ACGME-defined program requirements outlining curricular goals for US ophthalmology residency training programs, there is no comprehensive, national curriculum with detailed plans for instruction of necessary topics within the 36-month residency training period. Several articles identify a need for detailed curricula on various topics, propose ideas on how residency programs could create curricula, and explore ways of assessing resident competence. There is a paucity of literature evaluating how ophthalmology residents best learn various ophthalmology topics. We need to develop an intentional, comprehensive, and timely national curriculum for ophthalmology residency programs in the US, with detailed plans on how to meet curricular objectives and consideration of the most effective teaching strategies for different ophthalmology concepts.
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Rajendran S, Rajalakshmi AR, Srikanth K, Ezhumalai G. Manual small incision cataract surgery: a viable option for cataract with pseudoexfoliation. Int Ophthalmol 2021; 42:1447-1455. [PMID: 34839453 DOI: 10.1007/s10792-021-02134-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 11/12/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of the study was to assess the spectrum of clinical presentation, intraoperative challenges and immediate surgical outcome of cataract patients with pseudoexfoliation syndrome (PXF) following manual small incision cataract surgery (MSICS). METHODS This prospective observational study which was conducted in a rural tertiary care hospital included adult patients with cataract and associated PXF. MSICS was performed for all after a complete ophthalmic and systemic examination. Clinical profile, intraoperative and post-operative complications were noted. Uncorrected visual acuity on first day post-surgery was used to assess the surgical outcome following MSICS. RESULTS MSICS was performed in 80 eyes with varying grades of cataract and PXF. The mean age of the patients was 62.5 ± 8.9 years. PXF material on pupillary margin in 77(96%) patients was the most common finding noted. Majority of the patients had advanced cataract (72, 90%) and inadequate mydriasis (62, 77.5%). Posterior capsular rent (8, 10%) and zonular dehiscence (8, 10%) were the intraoperative difficulties faced. Uncorrected visual outcome on first post-operative day was moderate to good in 71 (88.8%) patients, limited by post-operative corneal oedema (21, 26.3%), iritis (31, 38.8%) and aphakia (9, 11.3%). CONCLUSION Patients with pseudoexfoliation had poor pupillary dilatation, advanced cataracts and higher rate of posterior capsular rent. Our study showed good outcome of MSICS in PXF patients, even with advanced cataract suggesting that MSICS is a safe, effective and viable option for patients with PXF and cataract.
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Affiliation(s)
- Sruthi Rajendran
- Anand Eye Hospital Clear Vision Centre, Trivandrum, Kerala, India.,Department of Ophthalmology, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth (SBV) Deemed to be University, Pondicherry, 607402, India
| | - A R Rajalakshmi
- Department of Ophthalmology, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth (SBV) Deemed to be University, Pondicherry, 607402, India.
| | - K Srikanth
- Department of Ophthalmology, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth (SBV) Deemed to be University, Pondicherry, 607402, India
| | - G Ezhumalai
- Senior Statistician & Research consultant, Mahatma Gandhi Medical College & Research Institute, Sri Balaji Vidyapeeth (SBV) Deemed to be University, Pondicherry, 607402, India
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Subudhi P, Patro S, Subudhi BNR, Sitaram S, Khan Z, Mekap C. Resident Performed Sutureless Manual Small Incision Cataract Surgery (MSICS): Outcomes. Clin Ophthalmol 2021; 15:1667-1676. [PMID: 33907380 PMCID: PMC8071211 DOI: 10.2147/opth.s290968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 04/01/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To show the surgical and visual outcomes of a resident-performed manual small incision cataract surgery. Study Type Retrospective observational case series. Study Setting Ruby Eye Hospital. Materials and Methods Manual small incision cataract surgery was performed on 339 uncomplicated cataract cases by three in-house residents. Preoperative visual acuity and vision with a pinhole were meticulously noted in the record sheets. All patients underwent thorough preoperative evaluation with the help of a slit lamp. Eyes with corneal guttae, un-dilated pupils, pseudo-exfoliation, raised intraocular pressure and posterior segment abnormalities were excluded from the study. The mean patient age was 59 years (min: 47 years and max: 85 years). Forty-seven percent were males, and the rest were females. The mean uncorrected preoperative visual acuity recorded was 1.3 logMAR units (max: 1 and min: 1.6, Std dev: 0.4). Forty-two percent of the eyes had dense nuclear cataracts (≥ Nuclear Sclerosis grade III from LOCS II). Results The mean postoperative visual acuity recorded was 0.4 logMAR units [standard deviation 0.3 logMAR units (max: 1 and min: 0.1 p-value <0.001)]. Forty-three cases (12.6%) had tunnel-related complications (premature entry/button hole). Thirty-six cases (10.6%) had iatrogenic prolapse of the iris tissue. Eight cases (2.3%) had a runaway capsulorhexis, while 18 cases (5.3%) had iatrogenic posterior capsular rupture. Two cases (0.58%) had a large zonular dialysis. Ten cases (2.9%) were retaken to the operating room again for repeat intervention. Conclusion The ophthalmic resident learning curve for manual small incision cataract surgery is steep, unlike what is reported in the literature. A good training program with a special emphasis on wound construction is of paramount importance for future residents.
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Affiliation(s)
- Praveen Subudhi
- Cataract Department, Ruby Eye Hospital, Berhampur, Ganjam, Odisha, India
| | - Sweta Patro
- Cataract Department, Ruby Eye Hospital, Berhampur, Ganjam, Odisha, India
| | - B Nageswar Rao Subudhi
- Cataract Department, Ruby Eye Hospital, Berhampur, Ganjam, Odisha, India.,Ophthalmology Department, Hitech Medical College, Bhubaneswar, India
| | - Silla Sitaram
- Cataract Department, Ruby Eye Hospital, Berhampur, Ganjam, Odisha, India
| | - Zahiruddin Khan
- Ophthalmology Department, Hitech Medical College, Bhubaneswar, India
| | - Chandan Mekap
- Cataract Department, Ruby Eye Hospital, Berhampur, Ganjam, Odisha, India
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Rana K, Bahrami B, van Zyl L, Esterman A, Goggin M. Efficacy of intracameral antibiotics following manual small incision cataract surgery in reducing the rates of endophthalmitis: A meta-analysis. Clin Exp Ophthalmol 2021; 49:25-37. [PMID: 33426771 DOI: 10.1111/ceo.13890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/20/2020] [Accepted: 11/27/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Manual small incision cataract surgery (MSICS) is a widely used technique for cataract surgery in the developing world. Higher rates of postoperative endophthalmitis have been reported with this technique compared with phaco-emulsification. The purpose of this study was to evaluate the efficacy of prophylactic intracameral (IC) antibiotics in reducing the rates of postoperative endophthalmitis following MSICS. METHODS Systematic review and meta-analysis of patients undergoing MSICS. A literature search in PubMed and EMBASE databases was performed to identify studies published from October 1992 to April 2020 evaluating MSICS with a minimum of 500 eyes reported. Two authors independently assessed eligibility, extracted data and assessed the risk of bias. Heterogeneity was assessed using the I2 test. RESULTS Twelve studies enrolling 1 494 307 eyes were included. IC antibiotics were used in 725 324 (48.5%) eyes. The risk ratio of developing endophthalmitis was 2.94 (95% CI, 1.07-8.12; P = .037) in eyes that did not receive IC antibiotics. CONCLUSIONS Routine use of IC antibiotics may help to reduce the rates of endophthalmitis following MSICS and significantly improve the safety of this effective form of cataract surgery.
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Affiliation(s)
- Khizar Rana
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Bobak Bahrami
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Lourens van Zyl
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Adrian Esterman
- Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Michael Goggin
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Discipline of Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, South Australia, Australia.,Department of Ophthalmology, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
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Ting DSJ, Chua D, May KO, Aung M, Kumar A, Farook M, Htoon HM, C A Sng C, Ang M. Modified manual small incision cataract surgery technique for phacoemulsification-trained surgeons. Ther Adv Ophthalmol 2020; 12:2515841420977372. [PMID: 33344883 PMCID: PMC7727050 DOI: 10.1177/2515841420977372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 10/23/2020] [Indexed: 01/09/2023] Open
Abstract
Purpose: To present the technique and outcomes of a modified manual small incision cataract surgery designed for the phacoemulsification surgeons who are learning to perform manual small incision cataract surgery. Methods: This was a retrospective, single-centred, comparative study. We included all the patients who underwent the modified manual small incision cataract surgery for visually significant cataract at Singapore National Eye Centre. All surgeries were performed by either a senior phaco-trained surgeon (M.A.) who had performed more than 500 manual small incision cataract surgery or a junior phaco-trained surgeon (D.C.) who had performed around 500 phacoemulsification but never performed any manual small incision cataract surgery. The main modification of this technique lies in the creation of an additional phaco-like main wound at 90° to the scleral tunnel wound, with most surgical steps performed through this additional wound. The outcomes were analysed and compared between the senior and junior surgeons. The main outcome measures were visual outcome and major intraoperative complications such as posterior capsular rupture and zonular dialysis. Results: A total of 132 cases were included; 102 (77.3%) and 30 (22.7%) cases were performed by the senior and junior surgeons, respectively. Pre-operatively, 85.6% eyes had best-corrected visual acuity of counting fingers or worse. Postoperatively, the visual outcome at 1 month was similar between the senior and junior surgeons, with 68.7% eyes achieving a best-corrected visual acuity of ⩾6/12 (p = 0.17). No posterior capsular rupture, zonular dialysis or endophthalmitis was observed during the study period. Conclusions: This modified technique may serve as a useful transition technique for the phaco-trained surgeons to develop skills in manual small incision cataract surgery, with demonstrable good visual outcome and safety.
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Affiliation(s)
- Darren S J Ting
- Academic Ophthalmology, School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Khin Oo May
- Sitagu International Missionary Association, Yangon, UK
| | - Mya Aung
- Sitagu International Missionary Association, Yangon, UK
| | | | | | - Hla M Htoon
- Singapore Eye Research Institute, Singapore; Ophthalmology and Visual Sciences, Duke - NUS Graduate Medical School, Singapore
| | - Chelvin C A Sng
- Singapore Eye Research Institute, Singapore; Department of Ophthalmology, National University Hospital, Singapore
| | - Marcus Ang
- Singapore National Eye Centre, 11 Third Hospital Avenue, Singapore 168751
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Sharma U, Sharma B, Kumar K, Kumar S. Evaluation of complications and visual outcome in various nucleus delivery techniques of manual small incision cataract surgery. Indian J Ophthalmol 2019; 67:1073-1078. [PMID: 31238414 PMCID: PMC6611319 DOI: 10.4103/ijo.ijo_1261_18] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose To evaluate various methods of nucleus delivery in manual small incision cataract surgery, with reference to visual outcome, intraoperative, and postoperative complications. Methods In this prospective randomized interventional study, five groups of 40 cases each were constituted, with reference to nucleus delivery technique: (a) phacosandwich, (b) fishhook, (c) irrigating vectis, (d) viscoexpression, and (e) anterior chamber maintainer (ACM). Visual outcome, intraoperative, and postoperative complications were evaluated in detail. Follow-up was done on first and seventh postoperative days (PODs) and then at fourth and eighth postoperative weeks. Results The most common intraoperative complication was intraoperative miosis, followed by intraoperative hyphema, seen more in phacosandwich and irrigating vectis groups. The most common postoperative complication was striate keratopathy followed by transient postoperative corneal edema and AC inflammatory response, seen more in phacosandwich and fishhook groups. With reference to visual acuity, on the first POD 95% cases of ACM group achieved visual acuity >+0.5 logMAR unit. The difference in the visual outcome among groups was statistically significant. On fourth and eighth postoperative weeks, best-corrected visual acuity among various groups was comparable. Conclusion ACM and viscoexpression are effective techniques for early visual rehabilitation. Fishhook has limited utility in softer nuclear grades and black cataracts. Phacosandwich is more suitable for nuclear sclerosis Grades 3-4. Irrigating vectis, viscoexpression, and ACM technique are effective techniques for all grades of nucleus Postoperative surgical-induced astigmatism was comparable in all techniques.
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Affiliation(s)
- Unnati Sharma
- Department of Ophthalmology, Gandhi Medical College, Bhopal, India
| | - Bhavana Sharma
- Department of Ophthalmology, Gandhi Medical College, Bhopal; Department of Ophthalmology, AIIMS, Bhopal, Madhya Pradesh, India
| | - Kavita Kumar
- Department of Ophthalmology, Gandhi Medical College, Bhopal, India
| | - Salil Kumar
- Department of Ophthalmology, Gandhi Medical College, Bhopal, India
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Arfeen SA, Fouad HM, Hassanein DH, Esmael AF, Awadein A. Outcomes and Complications Rate of Resident versus Attending Performed Eye Muscle Surgeries. Semin Ophthalmol 2019; 34:347-352. [PMID: 31132284 DOI: 10.1080/08820538.2019.1622024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: to compare the type, complications rate, and success rate of eye muscle surgeries performed by residents to those performed by attending consultants. Methods: A retrospective review was done on the charts of all children who underwent an eye muscle surgery in Cairo University Hospital during the period from January 2015 to December 2017. Preoperative data including age, sex, and type of deviation were tabulated. Details of the operative procedure including the surgeon, the type of eye muscle surgery, the number of muscles operated upon, perioperative complications, and the final ocular alignment at the end of the third month after surgery were recorded. Results: A total of 319 patients were included; 143 patients (315 muscles) in the supervised resident group and 176 patients (387 muscles) in the attending group. More vertical and oblique muscles surgeries were done by the attending consultants than by residents. Surgical success after three months was higher in the attending group (n = 126, 72%) than the resident group (n = 91, 64%). However, the difference was not statistically significant (P = .129). The perioperative complications rate was significantly higher (P = .004) in the resident group (14%) than the attending group (6%). Accidental scleral perforation was the most commonly encountered complication in the resident group (n = 6, 1.9%) followed by extruded/exposed Tenon (n = 5, 1.6%), and muscle slippage (n = 4, 1.3%). Conclusions: Success rate is similar in eye muscle surgeries performed by residents and attending consultants. However, perioperative complications are still more common among residents.
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Affiliation(s)
- Shaimaa A Arfeen
- a Ophthalmology Department, Cairo University, Faculty of Medicine , Cairo , Egypt
| | - Heba M Fouad
- a Ophthalmology Department, Cairo University, Faculty of Medicine , Cairo , Egypt
| | - Dina H Hassanein
- a Ophthalmology Department, Cairo University, Faculty of Medicine , Cairo , Egypt
| | - Amanne F Esmael
- a Ophthalmology Department, Cairo University, Faculty of Medicine , Cairo , Egypt
| | - Ahmed Awadein
- a Ophthalmology Department, Cairo University, Faculty of Medicine , Cairo , Egypt
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Zafar S, Chen X, Sikder S, Srikumaran D, Woreta FA. Outcomes of resident-performed small incision cataract surgery in a university-based practice in the USA. Clin Ophthalmol 2019; 13:529-534. [PMID: 30962673 PMCID: PMC6433105 DOI: 10.2147/opth.s198870] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose To assess outcomes of resident-performed small incision cataract surgery (SICS) at a single academic institute and to determine the availability of SICS-oriented educational resources in residency programs across the USA. Patients and methods A retrospective chart review was conducted on all patients who underwent SICS performed by postgraduate year 4 residents between January 2014 and January 2018 at the Wilmer Eye Institute, Baltimore, MD, USA. Postoperative visual acuity, intraoperative complications, and postoperative complications were the main outcomes measured. In addition, a survey was administered to all ophthalmology residency program directors in the USA to assess the presence of SICS-related content in their surgical training curriculum. Results Twenty-two eyes of 17 patients underwent planned resident-performed SICS, mainly for white cataracts. Intraoperative complications occurred in two (9.1%) eyes. The most common postoperative complication was transient increased intraocular pressure (two eyes, 9.1%). Mean preoperative best-corrected visual acuity (BCVA) was approximately 20/4,000. The large majority (95.2%) of eyes experienced improved BCVA following SICS, with a mean postoperative BCVA of 20/138 over an average follow-up of 4.2 months. Forty-seven programs responded to the survey (40.1% response rate). Residents were trained in SICS in 66.7% of these programs. However, more than half of all the programs did not have SICS-oriented educational resources available for residents. Conclusion Resident-performed SICS was found to be a safe and effective technique for cataract management. Considering the limited surgical volume for SICS in the USA, training programs might instead consider implementing SICS-oriented content in their surgical curriculum, including wet labs.
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Affiliation(s)
- Sidra Zafar
- Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD, USA,
| | - Xinyi Chen
- Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD, USA,
| | - Shameema Sikder
- Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD, USA,
| | - Divya Srikumaran
- Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD, USA,
| | - Fasika A Woreta
- Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, MD, USA,
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