Eyeworld

EW CATARACT 43 March 2019 by Stefanie Petrou Binder, MD, EyeWorld Contributing Writer Study highlights the factors affecting cataract operating time among trainees and consultants T he high volume of cataract cases at surgical centers re- quires cataract surgery to be quick and efficient. Accord- ing to a study presented at the 36th Congress of the European Society of Cataract and Refractive Surgeons (ESCRS), one-third of all cataract surgeries are now being done by trainees, leading to longer mean operating times and elevating the necessity for solid training and well-structured OR management. Assigning less complicated cases to trainees saves time and effort. "At all levels, including junior trainees, the mean operating time for cataract surgery is up to 30 minutes in uncomplicated cataract cases. Highly complex cataract cases will modestly increase operating times, but fortunately, they are limited in occurrence," said Paul Nderitu, MBChB, an intermediate fourth-year trainee in London, U.K., who reported the outcomes of a study he performed. New study Dr. Nderitu and Paul Ursell, con- sultant cataract surgeon, Epsom and St Helier NHS Trust, analyzed operation times in a study 1 that combined electronic records from two databases from January 2011 to December 2016 for patients who had undergone primary cataract surgery performed by consultants and first- to sixth-year trainees. The cases involved standard phacoemul- sification 2.0/2.2 mm and the implantation of injectable lenses. Patients who had combined proce- dures were excluded as were surger- ies performed by surgeons who had performed less than 50 surgeries (<0.5% of the database). Operating time was defined as the time between the patient entering and leaving the operating room, which included preoperative check, draping, phacoemulsifica- tion, IOL implantation, and undrap- ing, omitting anesthesia and surgery setup time. "Our definition of operating time is time out of surgery minus the time into surgery, which captures the full event. The main variable is the phacoemulsification time, which is quite consistent with and particular to each individual surgeon. We looked at many other factors that can influence the oper- ating time as well," Dr. Nderitu said. The study identified 11,067 cat- aract cases that fit the search criteria with operating times specified in 9,552 of them (86.3%), which were included in the analysis. Operating times reflected the surgeon's experi- ence, as expected. Dr. Nderitu found the mean times for cataract surgery to be: • Consultant: 19 minutes • First- to second-year trainees: 30 minutes • Third- to fourth-year trainees: 27 minutes • Fifth- to sixth-year trainees: 24 minutes Dr. Nderitu and Mr. Ursell devised a comprehensive cataract The 30-minute cataract 840 Walnut St., Philadelphia, PA 19107 | willseye.org | 877.289.4557 Wills Eye Hospital brings together leaders of every subspecialty in ophthalmology. It's a special place where "Skill with Compassion" is not just our motto, it's at our very core, our guiding principle. The world's home for ophthalmology. Jerry A. Shields, MD Ocular Oncology continued on page 44 Presentation spotlight

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