Photo Credit: Zarina Lukash

The following is a summary of “Resident operative time as an independent predictor of early post-operative cataract surgery outcomes and supervising attending surgeon impact: a retrospective case series,” published in the January 2024 issue of Ophthalmology by Andrews et al. 

The duration of resident involvement in cataract extraction and intraocular lens insertion (CE/IOL) procedures impacts early visual outcomes and postoperative recovery.

Researchers conducted a retrospective study to explore the potential of attending surgeons to decrease the operative time of residents in CE.

They enrolled 420 eyes from 400 patients at a single Veterans Affairs Hospital (VA Tennessee Valley Healthcare System) undergoing resident cataract surgeries after power analysis. The excluded cases involved attending surgeons as primary, laser-assisted procedures, or concurrent secondary interventions. Utilizing linear mixed effect models. The relationship between operative time and visual outcomes was assessed, considering covariates such as cumulative dissipated energy, preoperative factors, and intraoperative complications.

The result showed that the extended operative duration was found to have a statistically significant correlation with poorer pinhole visual acuity (PH-VA) on post-operative day 1 (POD1), even after adjusting for cumulative dissipated energy and other operative factors (P=0.049). Despite resident physicians serving as the primary surgeons, noticeable variations in operative times were observed among the ten supervising attending surgeons included in the study (P<0.001).

Longer resident cataract surgery times worsen early vision but not long-term outcomes, potentially mitigated by attending surgeons reducing surgery time for better early results.

Source: springer.com/article/10.1186/s12886-023-03278-5