|
 |
 |
|
Cataract Surgery In NSW-Is Registrar Training Safe? 1. Dr Rahul Dubey¹ ¹Sydney Eye Hospital Purpose: To prospectively assess the visual acuity outcomes of phacoemulsification surgery over a eight year period across two tertiary referral hospitals; and to compare the outcomes achieved by ophthalmology consultants and registrars in routine clinical practice and thus assess the appropriateness of patient allocation. Setting: Sydney Eye Hospital and Liverpool Hospital, New South Wales Australia Methods: This prospective observational study of phacoemulsification surgery involved 1812 cases from 1st July 2000 to 30th Dec 2008. Patients underwent detailed ophthalmic examination before and after surgery. Phacoemulsification and insertion of intraocular lens was performed by consultants, senior or junior registrars as allocated by the treating consultant. Postoperative review was conducted at one day, four weeks and three months after surgery. Results: Of the 1812 cases, 1596 cases (88.07%) were complication free. The mean postoperative visual acuity was 0.17 LogMAR (6/9), with 1630 cases (90.0%) achieving 0.30 LogMAR (6/12 Snellen equivalent) or better. Consultants, senior and junior registrars all achieved similar postoperative visual acuities of 0.154 – 0.17 LogMAR (p=0.5). There was a significantly different rate of vitreous loss (p=0.002) with consultants at 3.0% (9/309), senior registrars at 1.9% (15/804) and junior registrars at 5.3% (37/601). Conclusions: The visual acuity outcomes and complication rates confirm that quality care is being delivered to patients. The different complication rates between consultants and registrars reflect consultants allocating themselves more complicated cases and the training of junior registrars. The identical postoperative visual acuity showed that allocation of patients among consultants and registrars has been appropriate and good visual acuity outcomes were delivered to all patients. |
 |