EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/78719
February 2012 EW RESIDENTS 93 resident phaco surgery" forms, increasing the likelihood that these variables were addressed. This unique methodology brings this re- ported case series study design closer in rank to a prospective observa- tional study design, thus strengthen- ing the level of clinical evidence. Finally, a potential limitation is the nature of the analysis. To ade- quately rely on a multivariate analy- sis, one must identify all of the variables. While the authors do an excellent job identifying many vari- ables, one can always come up with more that were not included in the study (i.e., presence of cough during time of surgery, presence of hearing loss, and inability to follow com- mands during topical cases). New variables in this type of analysis could have a ripple effect, pushing new risk factors into the realm of statistical significance and bumping others out. Nonetheless, overall this is an excellent study that adds to the ex- isting body of literature and inspires new avenues for potential research. How should this study be used in clinical practice? In general, it may not change how case selection occurs. Basic principles of giving "easier" cases to beginning surgeons and more complex cases to ad- vanced surgeons still apply. Even though this study did not find the type of cataract to be statistically sig- nificant, it is doubtful that any training program will assign a ma- ture cataract with small pupils and a history of tamsulosin to a resident early in his or her surgical training. The authors describe various ques- tionnaires that have been developed to help guide case selection.2,3,4 Thoughtful case assignment coupled with a structured surgical curricu- lum5 will help optimize the training of the next generation of eye sur- geons. EW References 1. Blomquist PH, Morales ME, Tong L, Ahn C. Risk factors for vitreous complications in resi- dent-performed phacoemulsification surgery. J Cataract Refract Surg 2012; 38:208-214. 2. Muhtaseb M, Kalhoro A, Ionides A. A system for preoperative stratification of cataract pa- tients according to risk of intraoperative com- plications: a prospective analysis of 1441 cases. Br J Ophthalmol, 2004; 88(10):1242- 1246. 3. Habib MS, Bunce CV, Fraser SG. The role of case mix in the relation of volume and out- Product #24-4200 Receive a Free Toric Marker with Purchase come in phacoemulsification. Br J Ophthalmol 2005; 89(9):1143-1146. 4. Najjar DM, Awwad ST. Cataract surgery risk score for residents and beginning surgeons. J Cataract Refract Surg 2003; 29(10):2036-2037. 5. Rogers GM, Oetting TA, Lee AG, Grignon C, Greenlee E, Johnson AT, Beaver HA, Carter K. Impact of a structured surgical curriculum on ophthalmic resident cataract surgery compli- cations rates. J Cataract Refract Surg 2009; 35(11):1956-1960. Contact information Oetting: thomas-oetting@uiowa.edu Right On Target... The New A-Scan Plus®4.20 Meeting the Needs of Your Premium IOL Patient • Industry Leading Resolution • 100% Measurement Capability including dense cataracts • Automatic Alignment Detection • Simplified Personalization of Lens Constants • Unlimited patient data storage, recall, and transfer via USB Memory Stick Every purchase of an A-Scan Plus 4.20 comes with an on-site training program. 3222 Phoenixville Pike, Malvern, PA 19355 • USA 800-979-2020 • 610-889-0200 • FAX 610-889-3233 • www.accutome.com