Evaluation of complications of extracapsular cataract extraction performed by trainees

ABSTRACT

Background: Cataract extraction is the most common intraocular surgery taught to residents. Aim: This study aims to review the complications of trainee-performed extracapsular cataract extraction (ECCE) so as to identify the steps in which the trainee can benefit from closer supervision and practice. Subjects and Methods: This was a descriptive retrospective study of complications in the initial 150 ECCE with intraocular lens implant performed by two Ophthalmologists; from the University of Nigeria Teaching Hospital; Enugu; who visited a high volume training center. Both the intraoperative and early post-operative complications were studied. Data entry and analysis were performed descriptively using the Statiscal Package for the Social Sciences; SPSS version 15.0 (Chicago; IL; USA). Results: The age range of the patients was 40-95 years. The intraoperative complications included capsular flaps 12/161 (7.5); posterior capsule rent; 10/161 (6.2) and vitreous loss; 8/161 (5.0). Corneal complications (striate keratopathy; superior corneal edema; generalized corneal edema and corneal folds) ranked highest in post-operative complications accounting for 34 (56/164). Conclusions: Performance of adequate and proper anterior capsulotomy; minimal handling of the cornea and avoidance of posterior capsular rent are some of the challenges of the trainee in mastering ECCE. Stepwise supervised training can help a trainee master these steps while keeping the complications at acceptably low levels