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


METHODS
Prospective clinical cohort study.


METHODS
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.


METHODS
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.
Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Hawkesbury Road, Westmead, NSW 2145, Australia.
Calvin Sze-un
CS
Fong
Paul
P
Mitchell
Tania
T
de Loryn
Elena
E
Rochtchina
Thomas
T
Hong
Sudha
S
Cugati
Jie Jin
JJ
Wang
D000368:Aged; D002983:Clinical Competence / Q000592:standards*; D003253:Consultants; D004503:Education, Medical, Graduate; D004521:Educational Measurement; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D008297:Male; D008505:Medical Staff, Hospital / Q000592:standards*; D009517:New South Wales; D009885:Ophthalmology / Q000193:education / Q000592:standards*; D018918:Phacoemulsification / Q000193:education / Q000592:standards*; D011446:Prospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology