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Long-term outcomes of phacoemulsification cataract surgery performed by trainees and consultants in an Australian cohort

Authors

  • Calvin Sze-un Fong MBBS,

    1. Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, New South Wales
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  • Paul Mitchell PhD FRANZCO,

    1. Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, New South Wales
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  • Tania de Loryn MA DipClinPsych,

    1. Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, New South Wales
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  • Elena Rochtchina BSc MAppStat,

    1. Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, New South Wales
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  • Thomas Hong BAppSc(Orthoptics) MScMed(ClinEpi),

    1. Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, New South Wales
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  • Sudha Cugati MS PhD,

    1. Ophthalmology Department, Flinders Medical Centre, Flinders University, Adelaide, South Australia
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  • Jie Jin Wang MMed PhD

    Corresponding author
    1. Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Sydney, New South Wales
    2. Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia
      Dr Jie Jin Wang, University of Sydney, Department of Ophthalmology, Centre for Vision Research, Westmead Millennium Institute, Hawkesbury Road, Westmead, NSW 2145, Australia. Email: jiejin.wang@sydney.edu.au
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  • Competing/conflicts of interest: No stated conflict of interest.

  • Funding sources: Australian National Health & Medical Research Council, Canberra, Australia (Grant no. 302010, 2004–2006), Retina Australia (2005).

Dr Jie Jin Wang, University of Sydney, Department of Ophthalmology, Centre for Vision Research, Westmead Millennium Institute, Hawkesbury Road, Westmead, NSW 2145, Australia. Email: jiejin.wang@sydney.edu.au

Abstract

Background:  It is unclear whether differences exist in surgical complication rates and long-term visual acuity outcomes between patients whose phacoemulsification cataract surgery was performed by ophthalmological trainees and those performed by consultants.

Design:  Prospective clinical cohort study.

Participants:  1851 participants of the Cataract Surgery and Age-related Macular Degeneration study, aged ≥64 years, had cataract surgery performed at Westmead Hospital, Sydney.

Methods:  Surgical complication rates and visual acuity at 24-month postoperative visits were compared between patients who were operated on by trainees and those operated on by consultants.

Main Outcome Measures:  Surgical outcomes included operative complications recorded in surgical audit forms and 24-month postoperative visual acuity.

Results:  Of 1851 patients, 1274 (68.8%) were reviewed 24 months after surgery. Of these, 976 had data on the type of surgeon who performed the operation. After excluding 152 challenging cases and three cases operated on by first-year trainees at the beginning of their training, 821 patients were included in this study, of those, 498 were operated on by trainees and 323 by consultants. Habitual visual acuity ≥6/12 was achieved in 77.3% (n = 385/498) and 74.3% (n = 240/323), respectively, of the two groups of patients 24 months postoperatively. Of 514 patients who had surgical audit data, the major complication rate was numerically greater, but not significantly different for the 330 trainee-operated (6.1%) patients, compared with the 184 consultant-operated patients (2.7%, P = 0.091).

Conclusions:  We found relatively comparable complication rates and visual outcomes after 2 years between patients operated on by ophthalmological trainees and those by consultants, in a cataract surgical cohort at Westmead Hospital.

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