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CC BY-NC-ND 4.0 · Journal of Academic Ophthalmology 2021; 13(01): e26-e31
DOI: 10.1055/s-0041-1725582
Research Article

Outcomes of Femtosecond Laser Assisted Cataract Surgery Performed by Resident and Attending Surgeons

Spencer C. Cleland 
1   Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin
,
Daniel W. Knoch
1   Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin
,
Jennifer C. Larson 
1   Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin
› Author Affiliations Funding This study received its financial support from an unrestricted grant of Research to Prevent Blindness, Inc. (New York City, NY).
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Abstract

Objective The study aimed to evaluate the safety and efficacy of resident surgeons performing femtosecond laser assisted cataract surgery (FLACS).

Methods A retrospective chart review was conducted at the University of Wisconsin-Madison from postgraduate year four residents performing FLACS between 2017 and 2019. Data were also collected from residents performing manual cataract surgery, and attending surgeons performing FLACS for comparison. Recorded data included patient demographics, pre- and postoperative visual acuity, pre- and postoperative spherical equivalent, nuclear sclerotic cataract grade, ocular and systemic comorbidities, intraocular lens, duration of surgery, cumulative dissipated energy (CDE), and intraoperative and postoperative complications.

Results A total of 90 cases were reviewed with 30 resident manual cases, 30 resident FLACS cases, and 30 attending FLACS cases. Resident manual (25.5 ± 6.8 minutes) and resident FLACS (17.5 ± 7.1 minutes) cases took a significantly longer time to complete compared with attending FLACS cases (13.6 ± 4.4 minutes; p < 0.001). There was higher CDE in resident FLACS and resident manual cases compared with attending FLACS cases, but the difference was not statistically significant (p = 0.06). Postoperative visual acuity was not statistically different at 1-day and 1-month after surgery among the three groups. Resident FLACS complications, which included one case requiring an intraoperative suture to close the wound, two cases with intraoperative corneal abrasions, two cases with postoperative ocular hypertension, and one case with cystoid macular edema, were not significantly greater than attending FLACS complications (p = 0.30).

Conclusion The FLACS performed by resident surgeons had comparable visual acuity outcomes to FLACS performed by attending surgeons, and to manual cataract surgery performed by resident surgeons. However, resident FLACS cases took significantly longer time to complete, and they were associated with a higher CDE and minor complication rate compared with attending FLACS cases. Introducing advanced technologies into surgical training curricula improves resident preparedness for independent practice, and this study suggests FLACS can be incorporated safely and effectively into resident education.

Keywords

femtosecond-laser assisted cataract surgery - phacoemulsification - resident training - curriculum

Note

This study was conducted under the Declaration of Helsinki and approved by institutional review boards at the University of Wisconsin.


Supplementary Material



Publication History

Received: 14 June 2020

Accepted: 18 November 2020

Article published online:
26 February 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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