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Trainee cataract

Riyaz Bhikoo, Hans Vellara, Salome Lolokabaira, Neil Murray, Biu Sikivou, Charles McGhee
BACKGROUND: To describe patient demographics, visual and surgical outcomes of a cohort undergoing Small Incision Cataract Surgery (SICS) at a Pacific regional ophthalmic training facility. DESIGN: Prospective, longitudinal study conducted at the Pacific Eye Institute, Fiji. PARTICIPANTS: 156 patients underwent SICS. METHODS: Preoperatively, a complete ophthalmic examination, including pachymetry and macular Optical Coherence Tomography (OCT) performed by two independent investigators...
April 19, 2017: Clinical & Experimental Ophthalmology
Ann Sofia Skou Thomsen, Jens Folke Kiilgaard, Morten la Cour, Ryan Brydges, Lars Konge
PURPOSE: To investigate how experience in simulated cataract surgery impacts and transfers to the learning curves for novices in vitreoretinal surgery. METHODS: Twelve ophthalmology residents without previous experience in intraocular surgery were randomized to (1) intensive training in cataract surgery on a virtual-reality simulator until passing a test with predefined validity evidence (cataract trainees) or to (2) no cataract surgery training (novices). Possible skill transfer was assessed using a test consisting of all 11 vitreoretinal modules on the EyeSi virtual-reality simulator...
March 30, 2017: Acta Ophthalmologica
Mona Lotfipour, Ramunas Rolius, Erik B Lehman, Seth M Pantanelli, Ingrid U Scott
PURPOSE: To evaluate trends in cataract surgery training curricula and factors affecting timing of resident participation as a primary surgeon. SETTING: Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA. DESIGN: Cross-sectional study of anonymous survey results. METHODS: A description of the study and link to an online survey was e-mailed to program directors of each ophthalmology residency training program accredited by the Accreditation Council for Graduate Medical Education (ACGME)...
January 2017: Journal of Cataract and Refractive Surgery
Thanigasalam Thevi, Zin Maizura, Adinegara Lutfi Abas
INTRODUCTION: As in all surgeries, complications during cataract surgery are unavoidable and cause distress to the surgeon and the patient. This study was conducted to know the factors contributing to complications in our settings, to be able to counsel patients about complications and outcomes and to reduce litigations. MATERIALS AND METHODS: The secondary data analysis was conducted using the National Eye Database from 2007 to 2014. Demographic features, ocular comorbidities, technique of surgery, grade of surgeons, types of intraoperative complications, and reasons for not obtaining good visual acuity following intraoperative complications were studied...
January 2017: Indian Journal of Ophthalmology
Andrew C Pittner, Brian R Sullivan
PURPOSE: Comparison of resident surgeon performance efficiencies in femtosecond laser-assisted cataract surgery (FLACS) versus conventional phacoemulsification. PATIENTS AND METHODS: A retrospective cohort study was conducted on consecutive patients undergoing phacoemulsification cataract surgery performed by senior ophthalmology residents under the supervision of 1 attending physician during a 9-month period in a large Veterans Affairs medical center. Medical records were reviewed for demographic information, preoperative nucleus grade, femtosecond laser pretreatment, operative procedure times, total operating room times, and surgical complications...
2017: Clinical Ophthalmology
Bia Z Kim, Dipika V Patel, Charles Nj McGhee
IMPORTANCE: A contemporary benchmark for the most common ophthalmic surgery. BACKGROUND: To assess patient characteristics and outcomes of contemporary phacoemulsification cataract surgery in a New Zealand public teaching hospital setting. DESIGN: Prospective observational study. PARTICIPANTS: Consecutive cases (N = 500) of phacoemulsification surgery between April and June 2015. METHODS: An independent observer assessed all clinical and surgical data pre-operatively and 4-6 weeks post-operatively...
February 7, 2017: Clinical & Experimental Ophthalmology
Jay Kalliath, Gaurav Prakash, Kavitha Avadhani, Anitha Shakuntala
Posterior capsular opacification (PCO) is common after cataract surgery. Recurrence is very rare after a successful Yttrium aluminium-garnet (YAG) capsulotomy in adults. We report a case of visual axis re-opacification after a successful YAG capsulotomy for PCO in an adult. A 60-year male underwent phacoemulsification with +20.0 D acrylic hydrophobic intraocular lens implantation and silicon oil removal (SOR) five months after a successful retinal detachment repair. He underwent a capsulotomy after two months of surgery; however, the visual axis re-opacified after three more months...
October 2016: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
Nikolaos Mavrakanas, Kazim A Dhalla, Jerry Jecha, Imani Kapesa, Capucine Odouard, Ian Murdoch
PURPOSE: To evaluate the results and safety profile of assistant medical officer ophthalmologists (AMO-O) performing cataract surgery in the last stage of their surgical training, before their appointment to local communities. METHODS: We retrospectively analyzed the records of patients who underwent cataract surgery by AMO-Os at Dar es Salaam, Comprehensive Community Based Rehabilitation for Tanzania Disability Hospital between September 2008 and June 2011. Surgical options were either extracapsular cataract extraction (ECCE) or manual small incision cataract surgery (MSICS), both with polymethylmethacrylate intraocular lens implantation...
November 2016: Indian Journal of Ophthalmology
Dong Young Park, Andrew Walkden, Timothy A De Klerk
PURPOSE: To determine the effect of specialty training on cataract operation times and operating room efficiency. SETTING: Manchester Royal Eye Hospital, Manchester, United Kingdom. DESIGN: Retrospective consecutive case series. METHODS: Specialty training and consultant case times with preparation times were recorded between August 2014 and May 2015. Cases with posterior capsule rupture requiring anterior vitrectomy or iris hook insertion were analyzed...
September 2016: Journal of Cataract and Refractive Surgery
Bia Z Kim, Dipika V Patel, Trevor Sherwin, Charles N J McGhee
PURPOSE: To evaluate 2 preoperative risk stratification systems for assessing the risk of complications in phacoemulsification cataract surgery, performed by residents, fellows, and attending physicians in a public teaching hospital. DESIGN: Cohort study. METHODS: One observer assessed the clinical data of 500 consecutive cases, prior to phacoemulsification cataract surgery performed between April and June 2015 at Greenlane Clinical Centre, Auckland, New Zealand...
November 2016: American Journal of Ophthalmology
Kevin Dunne, Alex J Buller
AIM: To describe a useful technique utilizing lens thickness from biometric data as well as phacoemulsification (phaco) probe tip dimensions, in order to more accurately determine safe groove depth during divide and conquer techniques for cataract surgery. METHODS: Single center, selection of patients for cataract surgery deemed low risk and suitable for surgical teaching cases. Individual lens thickness measurements from biometry were calculated with known phaco tip dimensions to give an individualized safe number of phaco tip depths for grooving during divide and conquer...
2016: Clinical Ophthalmology
Alexander C Day, Sandeep K Dhallu, Vincenzo Maurino, Mark R Wilkins
OBJECTIVES: To describe the initial outcomes following installation of a cataract surgery laser system. SETTING: National Health Service cataract surgery day care unit in North London, UK. PARTICIPANTS: 158 eyes of 150 patients undergoing laser-assisted cataract surgery. INTERVENTIONS: Laser cataract surgery using the AMO Catalys femtosecond laser platform. PRIMARY AND SECONDARY OUTCOME MEASURES: HASH(0x4b7a470) PRIMARY OUTCOME MEASURE: intraoperative complications including anterior and posterior capsule tears...
2016: BMJ Open
Seema Ramakrishnan, Prabu Baskaran, Romana Fazal, Syed Mohammad Sulaiman, Tiruvengada Krishnan, Rengaraj Venkatesh
Achieving a formed and firm eyeball which is stably fixed in a holding device is a major challenge of surgical wet-lab training. Our innovation, the 'Spring-action Apparatus for Fixation of Eyeball (SAFE)' is a robust, simple and economical device to solve this problem. It consists of a hollow iron cylinder to which a spring-action syringe is attached. The spring-action syringe generates vacuum and enables reliable fixation of a human or animal cadaveric eye on the iron cylinder. The rise in intraocular pressure due to vacuum fixation can be varied as per need or nature of surgery being practised...
October 2016: British Journal of Ophthalmology
Meenakshi Swaminathan, Srikanth Ramasubramanian, Rachel Pilling, Junhong Li, Karl Golnik
Pediatric cataract surgical skill assessment is important to ensure the competency of the trainees, especially pediatric ophthalmology fellows. Using a rubric would ensure objectivity in this process. The ICO-OSCAR pediatric cataract surgery rubric has been developed with global variations in techniques of pediatric cataract surgery in mind.
August 2016: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Alexander C Day, Paul H J Donachie, John M Sparrow, Robert L Johnston
PURPOSE: To investigate time to pseudophakic retinal detachment (RD) after cataract surgery with posterior capsule rupture (PCR) to provide an evidence-based guide for postoperative management. DESIGN: Retrospective case series. PARTICIPANTS: A total of 61 907 eyes of 46 824 patients undergoing cataract surgery. METHODS: Subanalysis of the United Kingdom Royal College of Ophthalmologists' National Ophthalmology Database from 13 sites where data on both cataract and vitreoretinal surgery were recorded on the same electronic medical records system...
August 2016: Ophthalmology
Abigail T Fahim, Matthew P Simunovic, Zaid Mammo, Danny Mitry, Kaivon Pakzad-Vaezi, Patrick Bradley, Omar A Mahroo
OBJECTIVE: To compare key characteristics of ophthalmology training programs in 6 different English-speaking countries: Australia, New Zealand, Canada, Ireland, the United Kingdom, and the United States. PARTICIPANTS: Seven ophthalmologists with personal knowledge of all 6 systems contributed. METHODS: The main features examined were career pathway, duration of training, surgical training, governing bodies, and examination structure. Data were collected from the literature, online resources, and personal experience...
June 2016: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Danson V Muttuvelu, Carl Uggerhøj Andersen
PURPOSE: To address the use of and knowledge about skills assessment and competency-based training in cataract surgery in European Board of Ophthalmology (EBO) member countries. METHODS: A survey was emailed directly to all directors of the European societies in ophthalmology. The survey included queries about criteria to undergo training in cataract surgery, regulation of education in cataract surgery, and skills assessment and training methods. In addition, all Danish Eye Departments were further asked to what extent they find assessment tools useful, if competency-based training in cataract surgery would be an improvement, and if an assessment tool would be considered for use in future training of cataract surgeons...
June 2016: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
Avni P Finn, Sheila Borboli-Gerogiannis, Stacey Brauner, Han-Ying Peggy Chang, Sherleen Chen, Matthew Gardiner, Scott H Greenstein, Carolyn Kloek, Joan W Miller, Teresa C Chen
OBJECTIVES: To assess resident cataract surgery outcomes at an academic teaching institution using 2 Physician Quality Reporting System (PQRS) cataract measures, which are intended to serve as a proxy for quality of surgical care. DESIGN: A retrospective review comparing cataract surgery outcomes of resident and attending surgeries using 2 PQRS measures: (1) 20/40 or better best-corrected visual acuity following cataract surgery and (2) complications within 30 days following cataract surgery requiring additional surgical procedures...
September 2016: Journal of Surgical Education
Milind Suryawanshi, Parikshit Gogate, Anil N Kulkarni, Archana Biradar, Pooja Bhomaj
PURPOSE: Comparison of the rates of posterior capsule rupture (PCR) associated with conventional versus a reverse method of teaching phacoemulsification. METHODS: Trainees were taught conventional (start-to-finish) phacoemulsification beginning with an incision (tunnel construction) to capsulorhexis, sculpting, nucleus cracking, segment removal, cortex aspiration, intraocular lens implantation, and viscoelastic removal. In the reverse method, after incision and capsulorhexis, the trainees were progressively taught viscoelastic wash, cortex aspiration, segment removal, nucleus cracking, sculpting, and intraocular lens implantation...
April 2016: Middle East African Journal of Ophthalmology
A-Yong Yu, Qin-Mei Wang, Jin Li, Fang Huang, Karl Golnik
BACKGROUND: To investigate whether a short-term training program can produce competent cataract surgeons. METHODS: This observational pilot study enrolled 12 trainees who could not perform phacoemulsification independently. The training consisted of 2 phases. During the first 3-month phase, trainees were taught phacoemulsification through wet laboratory exposure and deliberate practice in patients at the training center in the Eye Hospital of Wenzhou Medical University in China...
September 2016: Journal of Surgical Education
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