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Risk factors for complications in resident-performed cataract surgery: A systematic review
Journal article   Peer reviewed

Risk factors for complications in resident-performed cataract surgery: A systematic review

Chaerim Kang, Matthew J Lee, Amy Chomsky, Thomas A Oetting and Paul B Greenberg
Survey of ophthalmology, Vol.69(4), pp.638-645
07/2024
DOI: 10.1016/j.survophthal.2024.04.002
PMID: 38648911

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Abstract

We assess risk factors for complications associated with resident-performed cataract surgery. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, we searched 4databases in September, 2023. We included peer-reviewed, full-text, English-language articles assessing risk factors for complications in resident performed cataract surgery. We excluded studies describing cataract surgeries performed by fellows, combined surgeries, and studies with insufficient information. Our initial search yielded 6244 articles; 15 articles were included after title/abstract and full-text review. Patient-related risk factors included older age, hypertension, prior vitrectomy, zonular pathology, pseudoexfoliation, poor preoperative visual acuity, small pupils, and selected types of cataracts. Surgeon-related risk factors included resident post graduate year and surgeon right-handedness. Other risk factors included absence of supervision, long phacoemulsification time, and phacoemulsification with high power and torsion. The quality of the studies was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation; most studies graded as moderate, primarily due to risk of bias. When assigning cases to residents, graduate medical educators should consider general and resident-specific risk factors to facilitate teaching and preserve patient safety.
 graduate medical education surgical complications risk stratification ophthalmology residency cataract surgery

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