Complication Rate and Corneal Endothelial Impact in Phacoemulsification Performed by Ophthalmology Residents at an Argentinian University Hospital

NEBOT LISANDRO; RUISEÑOR VÁZQUEZ PABLO; FERNÁNDEZ ABUYÉ LUCÍA; FERNÁNDEZ MENDY HERNÁN; GALLETTI JONATÁN; CHIARADÍA PABLO; GALLETTI JEREMÍAS GASTÓN

Fort Lauderdale, FL

Congreso; ARVO 2012 Annual Meeting; 2012

ARVO

Purpose:To assess the rate and type of complications and the induced corneal damage in phacoemulsification performed by residents at an Argentinian teaching hospital. Methods:Complications were extracted retrospectively from surgical video records and patient charts from May 2008 to September 2011. Specular microscopy was performed prospectively in 20 randomly selected patients before and 30 days after phacoemulsification in 2011. Results:Residents began to participate in phacoemulsification procedures in the fourth month of the first year of training. 2223 procedures were performed during the 41-month period under the supervision of 3 different instructors, of which 237 were not uneventful (10.7%). Complications by type (incidence) were posterior capsule rupture (60 cases, 2.7%), anterior capsule tear (12 cases, 0.5%), iris prolapse (34 cases, 1.5%), iatrogenic zonular dehiscence (26 cases, 1.2%), IOL inversion (7 cases, 0.3%), folded IOL haptic (22 cases, 1.0%), partial Descemet?s membrane detachment (8 cases, 0.4%) and iris dehiscence (2 cases, 0.01%). Pre- and postoperative mean corneal endothelial cell density was 2611 and 2133 cells/mm2, respectively (18% drop, 95% confidence interval: 10-26%). Conclusions:Despite the early surgical training, the overall rate and type of complications are comparable to those reported by other teaching centers in which residents began with phacoemulsification in the second year. However, complication rate rose significantly in the trimester in which new residents began their surgical training. The rate of complications in cataract surgery performed by residents in Argentina is acceptable with proper technique and supervision.