Visual outcomes of cataract surgery performed by supervised novice surgeons during training in rural China.
BACKGROUND
To assess the outcomes of cataract surgery performed by novice surgeons during training in a rural programme. DESIGN : Retrospective study.


METHODS
Three hundred thirty-four patients operated by two trainees under supervision at rural Chinese county hospitals.


METHODS
Two trainees performed surgeries under supervision. Visual acuity, refraction and examinations were carried out 3 months postoperatively.


METHODS
Postoperative uncorrected visual acuity, pinhole visual acuity, causes of visual impairment (postoperative uncorrected visual acuity < 6/18) RESULTS: Among 518 operated patients, 426 (82.2%) could be contacted and 334 (64.4% of operated patients) completed the examinations. The mean age was 74.1 ± 8.8 years and 62.9% were women. Postoperative uncorrected visual acuity was available in 372 eyes. Among them, uncorrected visual acuity was ≥6/18 in 278 eyes (74.7%) and <6/60 in 60 eyes (16.1%), and 323 eyes (86.8%) had pinhole visual acuity ≥ 6/18 and 38 eyes (10.2%) had pinhole visual acuity < 6/60. Main causes of visual impairment were uncorrected refractive error (63.9%) and comorbid eye disease (24.5%). Comorbid eye diseases associated with pinhole visual acuity < 6/60 (n = 23, 6.2%) included glaucoma, other optic nerve atrophy, vitreous haemorrhage and retinal detachment.


CONCLUSIONS
The findings suggest that hands-on training remains safe and effective even when not implemented in centralized training centres. Further refinement of the training protocol, providing postoperative refractive services and more accurate preoperative intraocular lens calculations, can help optimize outcomes.
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.
Wenyong
W
Huang
Ronghua
R
Ye
Bin
B
Liu
Qianyun
Q
Chen
Guofu
G
Huang
Yizhi
Y
Liu
David S
DS
Friedman
Nathan G
NG
Congdon
Jin
J
Ling
Mingguang
M
He
D000368:Aged; D000369:Aged, 80 and over; D002681:China; D002983:Clinical Competence / Q000592:standards*; D004503:Education, Medical, Graduate; D004521:Educational Measurement; D005260:Female; D006766:Hospitals, County; D006780:Hospitals, Rural; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology / Q000193:education*; D017060:Patient Satisfaction; D018918:Phacoemulsification / Q000193:education*; D011183:Postoperative Complications; D012029:Refraction, Ocular / Q000502:physiology; D012189:Retrospective Studies; D012424:Rural Population; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology*