title: Impact of Ophthalmic Surgeon Experience on Early Postoperative Central Corneal Thickness After Cataract Surgery.
abstract: OBJECTIVE
  To assess the impact of surgeon experience on early postoperative central corneal thickness (CCT) in eyes that have undergone phacoemulsification-based cataract surgery.
  
  
  METHODS
  One hundred sixty eyes underwent phacoemulsification-based cataract surgery performed by an experienced surgeon (n = 110; senior group) or a surgically less experienced ophthalmic assistant (n = 50; junior group), using the divide-and-conquer or tilt-and-tumble technique for cataractous lens extraction. The primary endpoint was postoperative corneal edema 2 hours after surgery, determined by pachymetry-based CCT.
  
  
  RESULTS
  Mean age of patients was 71.5 ± 9.1 years. Mean CCT at postoperative hour 2 was 622.8 ± 69.3 μm: an increase of 14.3% ± 10.8 from 545.3 ± 33.7 μm preoperatively (P = 0.0028). Mean CCT at postoperative hour 2 and postoperative corneal edema were significantly higher for the junior group than the senior group, with mean respective increases of 105.8 ± 81.4 μm (19.3% ± 14.2%) and 66.4 ± 3.7 μm (12.3% ± 8.3%), P = 0.0001. After adjustment for confounding factors, surgical experience was the only factor significantly associated with corneal edema: β = 39.58; SD = 11.05; P = 0.0005. Other intergroup differences observed included significantly longer mean operating and mean ultrasound times in the junior group than in the senior group. A final corneal suture was used more frequently in the senior than in the junior group, at rates of 32.7% and 2.0%, respectively, P < 0.0001.
  
  
  CONCLUSIONS
  Greater surgical experience was found to be associated with reduced early postoperative corneal edema, shorter operative time, and shorter ultrasound time. This suggests that beyond mastering the initial learning curve of phacoemulsification, surgical experience enables faster and safer surgery.
authors.affiliation: Department of Ophthalmology, CHR Metz-Thionville, Mercy Hospital, Metz, France.
authors.forename: Louis
authors.initials: L
authors.lastname: Lhuillier
authors.forename: Anne L
authors.initials: AL
authors.lastname: Jeancolas
authors.forename: Laurie
authors.initials: L
authors.lastname: Renaudin
authors.forename: Christophe
authors.initials: C
authors.lastname: Goetz
authors.forename: François
authors.initials: F
authors.lastname: Ameloot
authors.forename: Shanour
authors.initials: S
authors.lastname: Premy
authors.forename: Nadia
authors.initials: N
authors.lastname: Ouamara
authors.forename: Jean M
authors.initials: JM
authors.lastname: Perone
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence; D003315:Cornea / Q000000981:diagnostic imaging; D015715:Corneal Edema / Q000000981:diagnostic imaging / Q000209:etiology*; D063171:Corneal Pachymetry / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology; D012307:Risk Factors