Título

PROSPECTIVE STUDY ON RESIDENT-PERFORMED PHACOEMULFICATION SURGERIES: COMPLICATIONS AND OUTCOMES

Objetivo

This study aims to compare the outcomes and incidence of complications by resident-performed phacoemulsifications during 2nd, 3rd and 4th years

Método

A prospective evaluation of 424 consecutive resident-performed phacoemulsifications from Jun-2016 to Nov-2016. All surgeries were performed by 24 residents from UNICAMP (University of Campinas) tutored by a senior surgeon. We included surgeries performed by 10 second year residents (group R2), 9 third year residentes (R3) and 5 fourth year residentes (R4) evaluating: best corrected visual acuity before surgery, intra/post operative complications, techniques used for phacoemulsification, best corrected final visual acuity (at the 30th post operative) and endothelial parameters by especular microscopy and pachymetry before surgery and at the 60th day post-operatively

Resultado

In the R2 group there was 80 surgeries, R3 group 142 surgeries and R4 202 surgeries. The mean age was 70.3± 7.5 years-old; for group R2; 66.9± 9.2; for group R3; and 67.0± 12,0; for group R4. The BCVA before surgery was 0.26 ± 0.18. A total of 50 intra-operative complications was numbered (11.79% of all surgeries): 17 for group R2, 22 group R3 and 11 group R4. Among the complications: we had 31 posterior capsule tears, 19 vitreous loss, 2 nuclear loss into the vitreous, 6 aphakic, 2 wound burns, 4 zonular dialysis, 9 iris’ lesions. In long term monitoring, we observed no endophthalmitis and 2 cases of bullous keratophaty (1 in R2 and 1 in R3). Final BCVA has shown statistically significant improvement(p=0.001). Comparing specular microscopy before and at the 60th post-operative: there was no statistical difference in most of parameters: endothelium density (p=0.28), percentage of hexagonal cells (p=0,30), except for the CV (p=0.03). Likewise, pachymetry hasn’t shown statistical difference (p=0.08)

Conclusão

Despite the learning curve, surgical phacomeulsification performed by surgeon in training had low complication rates and good visual outcomes