Risk Factors for Complications in Resident-Performed Cataract Surgery: A Systematic Review

A systematic review on resident-performed cataract surgery has been published in the Survey of Ophthalmology, highlighting key risk factors for complications. The study, conducted by a team of researchers led by Paul B. Greenberg from Brown University, analyzed 15 peer-reviewed articles to identify factors associated with complications in resident-performed cataract surgery. The review found that patient-related risk factors included older age, hypertension, and prior vitrectomy, among others. Surgeon-related risk factors included resident postgraduate year and surgeon right-handedness. Other risk factors included absence of supervision, long phacoemulsification time, and phacoemulsification with high power and torsion. The study also noted that the quality of the studies was moderate, primarily due to the risk of bias.

Key Takeaways:

• Patient-related risk factors for complications in resident-performed cataract surgery include older age, hypertension, prior vitrectomy, zonular pathology, pseudoexfoliation, poor preoperative visual acuity, small pupils, and selected types of cataracts.
• Surgeon-related risk factors include resident postgraduate year and surgeon right-handedness.
• Other risk factors for complications include absence of supervision, long phacoemulsification time, and phacoemulsification with high power and torsion.
• The quality of the studies was moderate, primarily due to the risk of bias.
• The study highlights the importance of considering general and resident-specific risk factors when assigning cases to residents to facilitate teaching and preserve patient safety.

Statistics:

• 6244 articles were obtained from the initial search.
• 15 articles were included in the final analysis after title/abstract and full-text review.
• The studies included in the review were published between [no specific date mentioned] and were conducted in the United States with a focus on resident-performed cataract surgery.
• The primary databases searched were PubMed, Embase, Scopus, and Web of Science.
• The quality of the studies was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE).

Sources:

• Risk Factors for Complications In Resident-performed Cataract Surgery: a Systematic Review. Survey of Ophthalmology, 2024;69(4):638-645.
• Paul B. Greenberg et al. Brown University, Warren Alpert Medical School, Division of Ophthalmology, Providence, RI, United States.