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J. Bradley Randleman, MD; Jeremy D. Wolfe, MD; Maria Woodward, MD; Michael J. Lynn, MS; D. Hunter Cherwek, MD; Sunil K. Srivastava, MD

Arch Ophthalmol. 2007;125(9):1215-1219.

Objectives  To analyze outcomes of resident-performed phacoemulsifications and to assess the resident phacoemulsification learning curve.

Methods  Retrospective chart review of resident-performed phacoemulsification cases at the Atlanta Veterans Affairs Medical Center, Decatur, Georgia, from July 1, 1999, through June 30, 2002. Outcomes measured included postoperative uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), intraoperative complications, and adjusted phacoemulsification times (total phacoemulsification time multiplied by phacoemulsification power used).

Results  We analyzed 680 cases. Postoperative mean UCVA was 20/39, and mean BSCVA was 20/25 ( 20/20 in 44.0% of cases and  20/40 in 97.8%). There were no differences in visual acuity outcomes over the course of residency training. Intraoperative complications occurred in 34 cases (5.0%), with a significant reduction in vitreous loss rates after the first 80 resident cases (5.1% vs 1.9%; P = .03). Mean adjusted phacoemulsification time was 0.68 minutes, with a significant reduction in adjusted phacoemulsification time after the first 80 cases (0.87 vs 0.52 minutes; P < .001).

Conclusions  Quality visual outcomes after phacoemulsification can be attained throughout residency training; however, surgical competency, when measured by complication rates and phacoemulsification efficiency, continues to improve significantly with increasing surgical experience well beyond the first 80 resident phacoemulsification cases.

Author Affiliations: Departments of Ophthalmology (Drs Randleman, Wolfe, Woodward, Cherwek, and Srivastava) and Biostatistics, Rollins School of Public Health (Mr Lynn), Emory University, Atlanta, Georgia.

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RELATED LETTERS

Phacoemulsification Training
Katherine Masselos, Katelyn J.Y. Lee, Tani M. Brown, Louis W. Wang, Edwin C. Figueira, Vivek B. Pandya, and Ian C. Francis
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