The use of a pre-operative scoring system for the prediction of phacoemulsification case difficulty and the selection of appropriate cases to be performed by trainees.
BACKGROUND
To establish whether a previously validated scoring system (Habib) for the prediction of risk or likelihood of posterior capsule rupture during phacoemulsification surgery could be used to: 1. Predict the difficulty of a phacoemulsification case, and 2. Select appropriate phacoemulsification cases for trainees.


METHODS
The study sample was consecutive phacoemulsification cases undertaken by senior surgeons at a single ophthalmic unit over a three-week period (170 cases). Each case was scored using a potential difficulty scoring system. Immediately post-operatively, each case was given two scores by the operating surgeon (who was masked with regard to the potential complication score). The first score indicated the perceived difficulty of the case, and the second score, the degree of experience that they thought a trainee would require in order to have performed the same case without complication.


RESULTS
Using Cuzick's non-parametric test for trend, there was evidence for a trend of increasing perceived difficulty with increasing potential difficulty score (p = 0.05), and of increasing experience required with increasing potential difficulty score (p < 0.001)


CONCLUSIONS
The authors advocate that Habib's potential difficulty scoring system can be used to inform the surgeon of the likely difficulty of a phacoemulsification case and to aid selection of appropriate cases for trainees prior to surgery.
Osborne
Stuart A
SA
Sunderland Eye Infirmary, Queen Alexandra Road, Sunderland, SR2 9HP, UK. stuartosborne@doctors.org.uk
Severn
Phillip
P
Bunce
Catey V
CV
Fraser
Scott G
SG
D002387:Cataract Extraction / Q000379:methods*; D004503:Education, Medical, Graduate; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D016013:Likelihood Functions; D009885:Ophthalmology / Q000193:education; D018579:Patient Selection; D018918:Phacoemulsification / Q000009:adverse effects*; D011237:Predictive Value of Tests; D018570:Risk Assessment / Q000379:methods* / Q000592:standards; D012307:Risk Factors; D013337:Students, Medical; D011795:Surveys and Questionnaires