Intraoperative complication rates in cataract surgery performed by ophthalmology resident trainees compared to staff surgeons in a Canadian academic center

Abstract

To compare the intraoperative complication rates in cataract surgery performed by resident trainees and staff ophthalmologists. Kensington Eye Institute, University of Toronto, Toronto, Canada. Prospective case series. This study included 8738 consecutive cases of primary phacoemulsification cataract surgery performed by staff surgeons and resident trainees from January to December 2016. There were no exclusion criteria. Data collected included the level of resident training, case complexity, degree of resident involvement, and intraoperative complications. Primary outcome measures included intraoperative complication rates and level of complexity of cataract surgeries performed by resident trainees and staff surgeons. Resident trainees were involved in 44% of surgeries. Of those, 82% were completed in their entirety by a resident and 18% were performed by both the staff surgeon and resident. Staff surgeons performed 56% of all surgeries without resident involvement. Sixty-seven percent of surgeries were simple and 33% were complex, with small pupil or intraoperative floppy-iris syndrome being the most common reason for complex cases. For simple cases, there was no difference in the overall complication rates (1.7% and 2.0%; P=.52), posterior capsule rupture rates (0.9% and 0.8%; P=.76), or vitreous loss rates (0.4% and 0.2%; P=.08) between staff and residents, respectively. There were no differences in complication rates between the two groups.