Surgical Outcomes of Phacoemulsification Surgery in a Restructured Asian Training Hospital
Aim: To evaluate the surgical outcomes of phacoemulsification performed at National University Hospital, Singapore, with emphasis on the results achieved by residents.
Methods: This was a retrospective analysis of surgical outcomes of patients who underwent phacoemulsification in a restructured hospital in 2008. The study included 318 eyes of patients of predominantly Asian descent. Pre- and postoperative best-corrected visual acuity, perioperative complications and associations of patient, surgical and surgeon factors were studied. One-way analysis of variance for means, chi-squared test for proportions, and multivariate analyses were performed to determine factors associated with postoperative best-corrected visual acuity outcomes. Main outcome measures included postoperative best-corrected visual acuity, degree of improvement in best-corrected visual acuity, and achievement of specific best-corrected visual acuity targets of 6/9 and 6/12 at postoperative months 1 and 3.
Results: Duration of surgery of less than 20 minutes was found to be significantly associated with better postoperative best-corrected visual acuity. Level of surgical experience was also associated with better
postoperative best-corrected visual acuity at postoperative months 1 (p < 0.001) and 3 (p = 0.004). While senior consultants produced the best postoperative best-corrected visual acuity outcomes, the results achieved by residents were comparable to those reported in prior resident-only studies. For surgeries performed by residents, the overall rate of posterior capsule rupture was 3.1% with a 0.0% rate of vitreous loss.
Conclusions: The continued close guidance and training of ophthalmology residents in a restructured Asian training hospital will ensure that complication rates remain low while maintaining postoperative outcomes at safe levels.