Evaluation of the Correspondence between Preoperative Risk Factors and Intraoperative Complications in Resident-Performed Phacoemulsification

Abstract

<span style="font-family: 'Times New Roman','serif'; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi;"><span style="font-size: medium;">Introduction:</span></span><span style="font-family: 'Times New Roman','serif'; font-size: 10pt; mso-fareast-font-family: 'Times New Roman';">In this study, we aimed to evaluate the rates of preoperative risk factors and intraoperative complications in phacoemulsification, performed by ophthalmology residents. Moreover, we assessed the relationship between these risk factors and complications.</span> <br/><span style="font-family: 'Times New Roman','serif'; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi;"><span style="font-size: medium;">Materials and Methods:</span></span><span style="font-family: 'Times New Roman','serif'; font-size: 10pt; mso-fareast-font-family: 'Times New Roman';">In this prospective study, the rates of and the relationship between preoperative risk factors and intraoperative complications in resident-performed phacoemulsification were evaluated in the anterior segment clinic of Khatam-al-Anbia Eye Hospital, Mashhad, Iran.</span> <br/><span style="font-family: 'Times New Roman','serif'; font-size: 11pt; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi;">Results:</span><span style="color: windowtext; font-family: 'Times New Roman','serif'; font-size: 10pt; mso-fareast-font-family: 'Times New Roman';"> In total, medical records of 475 patients undergoing phacoemulsification by 13 ophthalmology residents, were evaluated. The rate of intraoperative complications was estimated at 17.5%. Moreover, the rate of major complications including posterior capsule rupture, zonular dehiscence and vitreous loss, with potential effects on the final surgical results, was 7.2%. Based on the univariate analysis, preoperative risk factors, which were significantly associated with the incidence of intraoperative complications, were as follows: poor red reflex (P=0.001), pseudoexfoliation (P=0.002), poor pupil dilation (P=0.003), corneal clouding (P=0.003), dense cataract (P=0.004), shallow anterior chamber (P‌=0.02) and advanced age (P<0.05).</span> <br/><span style="font-family: 'Times New Roman','serif'; mso-ascii-theme-font: major-bidi; mso-hansi-theme-font: major-bidi; mso-bidi-theme-font: major-bidi;"><span style="font-size: medium;">Conclusion: </span></span><span style="color: windowtext; font-family: 'Times New Roman','serif'; font-size: 10pt; mso-fareast-font-family: 'Times New Roman';">Considering the correspondence between intraoperative complications and some preoperative risk factors, careful preoperative examination or utilization of systematic risk stratification systems might facilitate the prediction of high-risk cases and prevention of complications in resident-performed phacoemulsification.</span>