Assessment of perceived difficulties by residents in performing routine steps in phacoemulsification surgery and in managing complications |
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Authors: | Gaurav Prakash Vishal Jhanji Namrata Sharma Kamlesh Gupta Jeewan S. Titiyal Rasik B. Vajpayee |
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Affiliation: | * Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India † Centre for Eye Research Australia, Victoria, Melbourne, Australia. |
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Abstract: | 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. |
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Keywords: | resident training phacoemulsification difficult situations management learning curve |
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