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EW CATARACT 35 February 2017 in 166 individuals in this group, of which 100% achieved 20/40 or better and 89% achieved 20/25 or better BCVA. Among patients who had phaco with pre-existing ocu- lar disease, 60% achieved 20/40 or better and 16% achieved 20/25 or better BCVA. In the ECCE subgroups, 83% of subjects with ECCE with no comor- bidities achieved 20/40 or better and 72% achieved 20/25 or better BCVA. One-third of ECCE patients with ocular comorbidities achieved 20/40 or better and 8% achieved 20/25 or better BCVA. The most common complication was posterior vitreous loss, seen in 3% of patients, followed by cystoid macular edema seen in 3.2%. Other complications included posterior cap- sule tear with no vitreous loss, rhexis problems, floppy iris syndrome, and other less common complications. The vitreous loss rates of 3.0% at the D.C. VAMC are comparable to the reported surgical outcomes of other academic institutions. Factors affecting outcomes In addition to pre-existing ocular pa- thologies, other factors played a de- cisive role in the surgical outcomes seen at the veteran's hospital, such as equipment upgrades and resident training. Dr. Magone explained, "Pre-existing diseases affecting visual outcomes resulted in decreased final postoperative vision and higher rates of cystoid macular edema compared to non-affected veterans. Howev- er, there was still significant visual improvement after cataract surgery, even with pre-existing disease. In 2005, the phaco equipment was up- graded to a newer machine, which improved the vitreous loss rates and decreased OR time significantly. The mean phaco surgical time before the upgrade was 71.7 minutes compared to 58.6 minutes (unpaired t-test p=0.0001), involving a difference of 13.1 minutes, after the upgrade. Similarly, the rate of vitreous loss decreased from 5.0% to 3.9%, after the upgrade." Of the surgeries reviewed in the study, 85% were performed by residents with attending supervi- sion. Resident training, although essential, is another factor affecting cataract surgical efficiency. Accord- ing to Dr. Magone, while the surgical teaching of ophthalmology residents is important in supporting academic programs and is safe with good vi- sual outcomes, it unfortunately also decreased OR time efficiency to 59% at the D.C. VA. This factor should be taken into account when evalu- ating the efficiency of OR time and surgical numbers at VA facilities. The VAMC in D.C. plays a major role in training ophthalmology residents from three different residency pro- grams. Currently, there are 20 oph- thalmology residents (including 16 Performing Cataract Surgeries? Pair your procedure with Endoscopic CycloPhotocoagulation (ECP) and effectively improve the surgical outcome of your glaucoma patients. Endo Optiks® Laser Endoscopy System ECP added to cataract extraction resulted in greater reduction in IOP and glaucoma medications than cataract extraction alone over a 3 year period.* * Francis, B., Berke, S., Dustin, L. and Noecker, R. (2014). Endoscopic cyclophotocoagulation combined with phacoemulsifi cation versus phacoemulsifi cation alone in medically controlled glaucoma. Journal of Cataract & Refractive Surgery, 40(8), pp.1313—1321. Endo Optiks® Laser Endoscopy System ECP added to cataract extraction resulted in greater reduction in IOP and glaucoma medications than cataract extraction alone over a 3 year period.* 1-866-906-8080 beaver-visitec.com A complete portfolio of ophthalmic products continued on page 36

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