Assessing the phacoemulsification learning curve using duration of each step
| Autor: | Jeremy Jones, Aditya Rali, Maria Aaron, Timothy Grosel, Elliot Moore, Jerry Fontus, Yousuf M. Khalifa |
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| Rok vydání: | 2022 |
| Předmět: |
medicine.medical_specialty
Phacoemulsification business.industry medicine.medical_treatment Nucleus disassembly Internship and Residency Cataract surgery Sensory Systems Surgery Ophthalmology Quadrant (abdomen) Cross-Sectional Studies Continuous curvilinear capsulorrhexis Education Medical Graduate Duration (music) medicine Humans Operative time Clinical Competence business Learning Curve |
| Zdroj: | Journal of Cataract and Refractive Surgery. 48:44-50 |
| ISSN: | 1873-4502 0886-3350 |
| Popis: | PURPOSE To assess the phacoemulsification learning curve for ophthalmology residents using duration for each step. SETTING Single tertiary, training site hospital. DESIGN Cross sectional study examining duration of cataract surgery steps as a function of categorized experience levels. METHODS Emory Ophthalmology PGY-3 and PGY-4 residents operating at Grady Memorial Hospital between April 2017 and February 2018 were eligible to participate. Duration in seconds for each step of surgery was calculated for incisions, continuous curvilinear capsulorrhexis (CCC), hydrodissection, nucleus disassembly, quadrant removal, cortical cleanup, intra-ocular lens insertion, closure, and this outcome was analyzed as a function of different experience levels. RESULTS 528 surgeries were included out of 549 total surgeries recorded. Six categories of experience levels were established A-F, increasing by increments of 50. There was an overall downward trend across various steps across the eight case categories, and several adjacent categories demonstrate statistically significant differences. The three most time-intensive steps early in training were nucleus disassembly (336.5 ± 16.5 secs), quadrant removal (275.1 ± 18.0 secs) and cortical cleanup (244.2 ± 24.6 secs). There was a sustained drop in mean duration for all steps through at least Category D, with most steps showing a drop through Category F. CONCLUSIONS There is a benefit to a higher case load, well above the ACGME-mandated 86 cases. Improvements in efficiency were observed after 250 cases with nuclear disassembly and CCC demonstrating a significant decrease in operative time. |
| Databáze: | OpenAIRE |
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