Comparison of Resident and Attending Cataract Surgical Outcomes
Purpose
To evaluate and compare resident and attending cataract (CE/IOL) surgical outcomes at the Kresge Eye Institute (KEI) and identify factors to improve departmental surgical performance and quality of surgical care.
Methods
A retrospective chart review of patients that had cataract CE/IOL by ophthalmology residents or attendings at KEI selected based on billing codes (CPT 66984 and 66982). A total of 200 cases were selected (100 attending and 100 resident). Pre-op variables were collected: patient demographics, resident or attending, best corrected visual acuity (BCVA) and target refraction. Post-op data included one month BCVA, refraction, complications and BCVA at three months. Outcome data was compared between attending and resident cataract surgeries and to the international benchmark goals for cataract surgery.
Results
Selected cases were subdivided into two groups: attending (a=532) and resident (r=532). Data included a total of 794 patients [a=400(50.4%); r=394(49.6%)], 525 females (a=268; r=257), 269 males (a=132; r=137), average age 65.59 years (a=69.58±10.37; r=61.57±9.16). Pre-op best corrected visual acuity (BCVA) averaged 20/60 (a=20/46; r=20/75; p=0.000), spherical equivalent averaged -0.44 (a= -0.53±3.07; r= -0.34±3.00; p=0.34) and target refraction -0.17 (a= -0.22±0.60; r= -0.12±0.32; p=0.002). Post-op BCVA (a=20/26; r=20/26; p=0.22) and post-op spherical equivalent (a= -0.20±0.90; r= -0.18±0.86; p=0.81) with 86.40% within one diopter of the target refraction (a=88.93%, r=83.86%,p=0.21).
Conclusion
There was no significant difference in pre- or post-operative spherical equivalent, post-op BCVA or percentage within one diopter of target refraction between the attending and resident groups. However, there was a significant difference in pre-operative BCVA and target refraction.