Intraoperative Complication Rate of Resident-Performed Phacoemulsification at Veterans Affairs Hospital: 4-Year Retrospective Review

Sunday, April 19, 2015: 1:46 PM
Room 5A (San Diego Convention Center)
Amanda Limbaugh, MD
John E. Weaver, MD

This study is a chart review for the purpose of calculating an intraoperative complication rate of resident-performed phacoemulsification surgery at the Ralph H. Johnson VA Medical Center in 2010, 2011, 2012, and 2013, comparing this rate to other published rates and to discuss the resident surgical training.

This is a retrospective chart review.  The data will be obtained from the VA electronic medical record system.  Every patient who had a scheduled phacoemulsification surgery performed primarily by a resident at the VA during 2010, 2011, 2012, and 2013 will be included.  The investigators will access these patient’s records and record whether the patient had any pre-existing conditions that would define them as a difficult case and if they had an intraoperative complication.  This will include posterior capsule tear, vitreous loss, or any complication that required re-operation within 90 days of surgery. The data will be collected strictly in chronological order.

Preliminary results include for 2010, 2011, and 2012 there were 1858 phacoemulsifications performed.  Vitreous loss occurred in 39 (2.1%) of the cases, posterior capsular tear without vitreous loss occurred in 11 (0.6%) of the cases, and 7 (0.4%) of the cases went back to the operating room due to complications within 90 days of the initial surgery (six of these cases having intraoperative complications as well).  A total of 51 out of 1858 (2.7%) resident performed phacoemulsification cases had a complication.

Preliminarily, in the published literature reviewed so far, intra-operative complication rates for resident-performed phacoemulsification surgery range from 2.0% to 14.7%.  Also, many institutions have reported that they used their complication rates and self-evaluations to improve their outcomes whether their rate was high or already low.