Trends in Resident Cataract Surgery Complication Rates Under A Single Experienced Supervising Attending

Abstract

Purpose: To evaluate resident surgical complication rates under the supervision of an experienced attending surgeon over five years. Setting: A single academic medical center at University of North Carolina at Chapel Hill, Chapel Hill, NC. Design: Retrospective chart review. Methods: Retrospective review of the first 30e50 cases performed by five classes of residents supervised by a single experienced attending surgeon with over twenty years of experience as a surgical educator. Data was collected from Accreditation Council for Graduate Medical Education (ACGME) surgical logs and operative notes. Preoperative risk factors, operative technique, and intraoperative complication rates were analyzed. Results: A total of 1028 cataract cases over the five-year study period were reviewed and 890 cases in 645 patients were included. The overall complication rate was 14.4 % with no significant trend observed in the rate of intraoperative complications across study years. Multivariate analysis found that complications during cataract surgery were more likely to occur in eyes with a preoperative risk factor (p < 0.001). There was a significant difference in mean post-operative BCVA among complicated (20/28) and uncomplicated (20/21) cases (p < 0.001). Conclusion: Cataract surgery outcomes across multiple classes of residents were consistent under the supervision of an experienced attending surgeon. Despite the overall higher complication rate for complex cases, visual outcomes remained excellent. This may be an indication of the ability of an experienced attending surgeon to allow more resident surgical autonomy while maintaining good outcomes for the patient.