Eyeworld

22 | EYEWORLD | MAY 2020 ASCRS NEWS from including additional residency programs if the diverse role of volunteer vs. full time attending faculty were being evaluated. Second, the study noted mostly intraoperative complica- tions; however, many significant complications of cataract surgery such as endophthalmitis, postoperative inflammation, and postoper- ative elevated pressure occur days after the surgery. These complications would be helpful in comparing full time vs. volunteer faculty as they could provide details on differences in supervision in the postoperative period. Final- ly, an increased number of intermediate- and high-complexity cases would have allowed for more robust analysis of the differences in com- plication rates between full time and volunteer faculty in more complex cases. Ultimately, the goal of this study was to determine whether attending teaching experi- ence plays a role in intraoperative complication rates in resident cataract cases, assuming that full time faculty spend more time in their ca- reers working and operating with the residents. Volunteer vs. full time faculty status does not necessarily reflect years of teaching experience, studies looking at high-risk factors for cataract surgery complications. The scale's accuracy was verified by the fact that the complication rates increased with increased risk category. The third strength is that this study only included expe- rienced attendings that were 10 years or more post-residency. Having extensive surgical expe- rience helped decrease bias regarding surgeon skill and allowed the study to focus on teaching ability. Finally, this study used a clustered logis- tic regression model to decrease biases between individual surgeons. The limitations of this paper are as follows. First, this study was limited to data from only one residency program. Different factors within that program such as internal bias toward attending selection, attending availability, and attending preference for second- vs. third-year ophthalmology residents could have played a role in the rates of intraoperative complications. Additionally, clarification of when residents were allowed to perform more complex cases based on their level of training would be valu- able as this could directly affect complication rates as well. The study would have benefited continued from page 20 References 1. Kim DS, et al. Implementing a teaching service for voluntary faculty in obstetrics and gynecology: long-term results. J Reprod Med. 2013;58:371–376. 2. Najjar DM, Awwad ST. Cataract surgery risk score for residents and beginning surgeons. J Cataract Refract Surg. 2003;29:2036–2037. 3. Gupta A, et al. Cataract classifi- cation system for risk stratification in surgery. J Cataract Refract Surg. 2011;37:1363–1364. 4. Puri S, et al. Comparing resident cataract surgery outcomes under novice versus experienced attend- ing supervision. Clin Ophthalmol. 2015;9:1675–1681. 5. Rutar T, et al. Risk factors for intraoperative complications in resident-performed phacoemul- sification surgery. Ophthalmology. 2009;116:431–436. 6. Woodfield AS, et al. Intraoperative phacoemulsification complication rates of second- and third-year ophthalmology residents a 5-year comparison. Ophthalmology. 2011;118:954–958. 7. Blomquist PH, et al. Validation of Najjar-Awwad cataract surgery risk score for resident phacoemulsifi- cation surgery. J Cataract Refract Surg. 2010;36:1753–1757. 8. Briszi A, et al. Complication rate and risk factors for intraoperative complications in resident-performed phacoemulsification surgery. Graefes Arch Clin Exp Ophthalmol. 2012;250:1315–1320. 9. Biró Z, Kovacs B. Results of cataract surgery in previously vit- rectomized eyes. J Cataract Refract Surg. 2002;28:1003–1006 10. Ellis EM, et al. Complication rates of resident-performed cataract surgery: Impact of early introduction of cataract surgery training. J Cataract Refract Surg. 2018;44:1109–1115. 11. Zafar S, et al. Outcomes of resident-performed small incision cataract surgery in a university- based practice in the USA. Clin Ophthalmol. 2019;13:529–534. n n n n Effect of full time vs. volunteer faculty on resident cataract surgery complications Murtaza Saifee, MD, Ivy Zhu, MD, Ying Lin, MSPH, Catherine Oldenburg, PhD, Saras Ramanathan, MD J Cataract Refract Surg. 2020;46(5);700–704. n Results: Out of 1377 cases, 101 had complications. Among low-risk cases, full-time teaching attendings (25/619=4.04%) had a similar complication rate to volunteer attendings (17/387=4.39%) (OR 0.92; p=0.79). In intermediate-risk cases, full-time teaching attendings (28/195=14.36%) had a slightly worse complication rate than volunteer attendings (10/88=11.36%) (OR 1.63; p=0.45). High-risk cases had the highest complication rates, with full- time teaching attendings' complication rates (16/72=22.22%) somewhat lower than volunteer attendings' (5/16=31.25%) (OR 0.64; p=0.48). n Conclusion: For low-risk resident-performed cataract surgeries, supervision by full-time faculty and volunteer attendings yield similar complication rates; thus, residency programs may safely recruit volunteer attendings to supervise low-risk cataract surgeries to support resident training. Analysis of higher-risk cases was limited by low surgical volume. n Purpose: To examine the effect of teaching experience of supervising surgeons on resident cataract surgery intraoperative complication rates. n Setting: Zuckerberg San Francisco General Hospital, Department of Ophthalmology, University of California, San Francisco, California. n Design: Retrospective chart review n Methods: Cataract surgeries performed by UCSF ophthalmology residents from 2010 to 2017 were reviewed. Only cases supervised by anterior segment attendings with more than 10 years post-residency surgical experience were included. Cases were categorized as being supervised by either full-time UCSF teaching attendings or volunteer private practice attendings. Cases were graded as low risk (0 risk factors), intermediate risk (1 risk factor) or high risk (>=2 risk factors) based on 8 pre- and intraoperative risk factors. Complication rates were compared between the two attending groups among varying risk grades.

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