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. 2021 Apr;35(4):1213-1220.
doi: 10.1038/s41433-020-1057-z. Epub 2020 Jul 1.

Incidence, characteristics, outcomes and confidence in managing posterior capsular rupture during cataract surgery in the UK: an ophthalmology trainees' perspective

Michael Grinton #  1 , Jaswant Sandhu #  2 , Audrey Shwe-Tin  3 , David H W Steel  4   5 , Darren Shu Jeng Ting  6   7 ; North East Trainee Research in Ophthalmology Network (NETRiON)
Collaborators, Affiliations

Incidence, characteristics, outcomes and confidence in managing posterior capsular rupture during cataract surgery in the UK: an ophthalmology trainees' perspective

Michael Grinton et al. Eye (Lond). 2021 Apr.

Abstract

Purpose: To examine the incidence, characteristics and outcomes of posterior capsular rupture (PCR) cases amongst the ophthalmology trainees and to evaluate the trainees' confidence in managing PCR.

Methods: A two-staged cross-sectional study was carried out between September 2017 and April 2018 in the North East of England, UK. All ophthalmology trainees were surveyed on their confidence level in managing PCR and the characteristics and outcomes of their PCR cases.

Results: Fifteen (71.4%) out of 21 trainees completed the study. The mean number of phacoemulsification was 268.9 ± 250.9 cases (range, 0-705) per trainee. There were 82 (1.9%) cases of PCR reported among 4303 phacoemulsification. PCR occurred most commonly during quadrant removal (44.0%) and cortex removal (21.3%). The best-corrected visual acuity (in logMAR) improved significantly from 0.47 ± 0.32 preoperatively to 0.20 ± 0.19 postoperatively (p < 0.001). The supervising consultant took over 80.5% of the PCR cases. The PCR rate decreased significantly from 3.1% at 0-100 cases to 0.6% at 301-400 cases (p = 0.004) and to 0.4% at >500 cases (p = 0.005). Confidence in managing PCR (without supervision) improved from 0% (9/9) at junior level to 50% (3/6) at senior level, and the average number of anterior vitrectomies performed was 0.6 ± 0.9 (range: 0.0-2.0).

Conclusions: We observed a low PCR rate among the trainees in our region, with the majority of cases achieving good visual outcome. A significant reduction in PCR rate was observed at the threshold of >500 cases. There is however a lack of confidence among trainees in managing PCR, highlighting the need for devising new training strategies in this area.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Summary of stages of cataract surgery (performed by ophthalmology trainees) when posterior capsular rupture occurred.
Fig. 2
Fig. 2
Influence of the seniority of trainees on the supervisor’s take-over rate during the management of posterior capsular rupture.
Fig. 3
Fig. 3
Pre- and post-operative best-correct visual acuity of cataract surgery with posterior capsular rupture among ophthalmology trainees.
See this image and copyright information in PMC

References

    1. https://ec.europa.eu/eurostat/statisticsexplained/index.php/Surgical_ope.... Accessed 2 May 2020.
    1. Minassian D, Reidy A. Future Sight Loss UK: an epidemiologic and economic model for sight loss in the decade 2010-20. A RNIB report; 2009.
    1. The Royal College of Ophthalmologists. National Ophthalmology Database Audit, year 4 annual report—the third prospective report of the National Ophthalmology Database Audit; 2019.
    1. Ionides A, Minassian D, Tuft S. Visual outcome following posterior capsule rupture during cataract surgery. Br J Ophthalmol. 2001;85:222–4. doi: 10.1136/bjo.85.2.222. - DOI - PMC - PubMed
    1. Sparrow JM, Taylor H, Qureshi K, UK EPR user group. The Cataract National Dataset electronic multi-centre audit of 55,567 operations: risk indicators for monocular visual acuity outcomes. Eye. 2012;26:821–6. doi: 10.1038/eye.2012.51. - DOI - PMC - PubMed