Trends in cataract surgery training curricula

Abstract

Purpose: To evaluate trends in cataract surgery training curricula and factors affecting timing of resident participation as a primary surgeon.

Setting: Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA.

Design: Cross-sectional study of anonymous survey results.

Methods: A description of the study and link to an online survey was e-mailed to program directors of each ophthalmology residency training program accredited by the Accreditation Council for Graduate Medical Education (ACGME).

Results: Fifty-one (44%) of the 116 program directors completed the survey. First-year, second-year, and third-year residents performed a mean of 2, 25, and 155 phacoemulsification surgeries, respectively, as a primary surgeon. Only 1 program (2%) required residents to perform extracapsular cataract extraction (ECCE) before performing phacoemulsification. Clear corneal phacoemulsification was the first technique taught to trainees at 91% of programs. More than two thirds (71%) of program directors indicated that their program had a cataract surgery training curriculum designed to transition residents gradually to the operating room. These curricula included structured wet laboratory (92%) and lecture (89%) components. Inadequate resident knowledge and surgical skill base (57%) and anticipation of increased surgical complication risk (37%) were the most commonly reported factors impeding earlier exposure to phacoemulsification in residency.

Conclusions: Results show that residents today begin surgical training with phacoemulsification rather than ECCE, perform a higher number of phacoemulsification surgeries than is required by the ACGME, and begin performing phacoemulsification as early as their first or second year of residency. Despite these evolutions, 29% of respondent ACGME-accredited ophthalmology residency programs reported not having a formal cataract surgery training curriculum.