Purpose To analyze the learning curve of phacoemulsification performed by residents without ECCE experience in step-by-step training program (SBSTP).
Method Consecutive surgical records of phacoemulsification performed by 4 residents without previous ECCE experience from March 2009 to Sept 2011 were reviewed retrospectively. Completion rate of the first 30 cases of each resident was calculated. Main intra-operative phaco parameters records for the first 30 surgeries of each resident was compared with that of their last 30 surgeries. Intra-operative complications in the residents’ performed cases were recorded and analyzed as well.
Results By the time we reviewed ,1013 cases were performed by residents. The completion rate for the first 30 phaco cases was 79.2±5.79%. The main quitting reasons were: anterior capsule tear, unable to crake the nucleus, posterior capsular rupture during phaco or I/A. Cumulative dissipated energy of phaco power used during the surgeries was statistically significantly less in the last 30 cases than the first 30 cases (30.10±17.58 vs 55.41±37.59, t=2.457, P=0.021). Posterior capsular rupture rate was 2.75±1.15% as total (10.83±4.19% in the first 30 cases and 1.67±1.92% in the last 30 cases, χ2 =99.23, P=0.00, statistically significant difference).
Conclusion SBSTP might be a necessary process for a resident to transit from dependency to a self–supported operator. It is also an essential step between wet lab training to OR practicing whole procedure independently and safely. |
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