Impact of Ophthalmic Surgeon Experience on Early Postoperative Central Corneal Thickness After Cataract Surgery

Lhuillier, Louis; Jeancolas, Anne L.; Renaudin, Laurie; Goetz, Christophe; Ameloot, Francois; Premy, Shanour; Ouamara, Nadia; Perone, Jean‐Marc

doi:10.1097/ico.0000000000001175

Cited by 29 publications

(40 citation statements)

References 25 publications

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“…Although phacoemulsification is a safe procedure, the risk of endothelial cell loss is inherent due to the intraocular maneuvers involved. [13][14][15][16][17][18] In this study, surgical outcomes in surgeries performed by a group of 10 ophthalmology residents at the University of Campinas (UNICAMP) over the course of 18 months of phacoemulsification training (July 2016 to January 2018) were compared. We retrospectively analyzed intraoperative complications, as well as pre-, intra-, and postoperative parameters, in order to compare outcomes among residents of different training levels.…”

Section: Introductionmentioning

confidence: 99%

Comparing Resident Outcomes in Cataract Surgery at Different Levels of Experience

Mélega¹,

Lira²,

Silva³

et al. 2020

OPTH

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Section: Introductionmentioning

confidence: 99%

Comparing Resident Outcomes in Cataract Surgery at Different Levels of Experience

Mélega¹,

Lira²,

Silva³

et al. 2020

OPTH

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“…Moreover, few studies have evaluated important related parameters such as pachymetric variation (14) or endothelial cell loss. (15) The present study assessed a consistently larger number of surgeries performed by the same group of residents and has also provided a comprehensive analysis of ocular parameters.…”

Section: Discussionmentioning

confidence: 99%

“…Although phacoemulsi cation is a safe procedure, the risk of endothelial cell loss is inherent due to the intraocular maneuvers involved. (14)(15)(16)(17)(18)(19) In this study, surgical outcomes in surgeries performed by a group of 10 ophthalmology residents at the University of Campinas (UNICAMP) over the course of 18 months of phacoemulsi cation training were compared. We retrospectively analyzed intraoperative complications, as well as pre-, intra-, and postoperative parameters, in order to compare outcomes among residents of different training levels.…”

mentioning

confidence: 99%

“…The aforementioned parameters are also highly relevant but rarely considered in studies of ophthalmology residents' surgical skills and have therefore been included in this study to better support any conclusions regarding the impact of surgeon experience on outcomes. (4,5,15,(6)(7)(8)(9)(10)(11)13,14) This study evaluated ophthalmology residents' outcomes for cataract surgery over the course of three consecutive training periods at the University of Campinas (UNICAMP).…”

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confidence: 99%

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Comparing Resident Outcomes in Cataract Surgery at Different Levels of Experience: A retrospective case series

Mélega

Lira

Silva

et al. 2020

Preprint

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BackgroudTo evaluate outcomes of resident-performed cataract surgeries in different training levels in a retrospective case series.MethodsA total of 730 surgeries performed by residents were evaluated into three groups: surgeries performed during residents’ first semester of training in phacoemulsification (S1), surgeries performed during the second semester (S2), and surgeries performed during the third semester (S3). The primary outcome was the incidence of intraoperative complications in each group. Secondary outcomes were the comparisons between initial and final corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell density (ECD), and central corneal thickness (CCT) in each group. Descriptive statistical analyses were employed in the presentation of the results using central tendency and variance measurements. The groups’ continuous variables were compared using the t-test or ANOVA (parametric variables) or the Mann-Whitney or Kruskal-Wallis tests (non-parametric variables). Statistical analyses of the categorical variables were performed using Fisher’s exact test or the chi-squared test.ResultsThe rate of complications within six weeks of follow up was 24 out of 102 eyes (23.53%) in the S1 group, 63 out of 301 eyes (20.93%) in the S2 group, and 37 out of 327 (11.31%) in the S3 group (p = 0.001). There was no significant difference in CDVA (p = 0.298), ECD (p = 0.067), IOP (p = 0.217), or CCT (p = 0.807) between the groups.ConclusionsWhen measured by rates of complications and by the aforementioned parameters, surgical competency was found to improve as surgical experience and frequency increased. Therefore, this study identified some patterns of skill development that can be applied to teaching strategies and better assist surgeons in training.

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“…For example, an increased risk of postoperative complications is reported for surgeons who have performed less than 500 gastric bypass surgeries compared to surgeons who have performed more than 500 surgeries 1 . It has been reported that the risk of patients developing reactive corneal edema as determined by the central corneal thickness 2 hours after surgery was about 1.6 times higher for novice surgeons performing cataract surgery than surgeons with experience 2 . Thus, shortening the learning curve of a surgical technique is reported to be one of the most important challenges in medicine.…”

Section: Introductionmentioning

confidence: 99%

Real-Time Extraction of Important Surgical Phases in Cataract Surgery Videos

Morita

Tabuchi²,

Masumoto³

et al. 2019

Sci Rep

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The present study aimed to conduct a real-time automatic analysis of two important surgical phases, which are continuous curvilinear capsulorrhexis (CCC), nuclear extraction, and three other surgical phases of cataract surgery using artificial intelligence technology. A total of 303 cases of cataract surgery registered in the clinical database of the Ophthalmology Department of Tsukazaki Hospital were used as a dataset. Surgical videos were downsampled to a resolution of 299 × 168 at 1 FPS to image each frame. Next, based on the start and end times of each surgical phase recorded by an ophthalmologist, the obtained images were labeled correctly. Using the data, a neural network model, known as InceptionV3, was developed to identify the given surgical phase for each image. Then, the obtained images were processed in chronological order using the neural network model, where the moving average of the output result of five consecutive images was derived. The class with the maximum output value was defined as the surgical phase. For each surgical phase, the time at which a phase was first identified was defined as the start time, and the time at which a phase was last identified was defined as the end time. The performance was evaluated by finding the mean absolute error between the start and end times of each important phase recorded by the ophthalmologist as well as the start and end times determined by the model. The correct response rate of the cataract surgical phase classification was 90.7% for CCC, 94.5% for nuclear extraction, and 97.9% for other phases, with a mean correct response rate of 96.5%. The errors between each phase’s start and end times recorded by the ophthalmologist and those determined by the neural network model were as follows: CCC’s start and end times, 3.34 seconds and 4.43 seconds, respectively and nuclear extraction’s start and end times, 7.21 seconds and 6.04 seconds, respectively, with a mean of 5.25 seconds. The neural network model used in this study was able to perform the classification of the surgical phase by only referring to the last 5 seconds of video images. Therefore, our method has performed like a real-time classification.

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Impact of Ophthalmic Surgeon Experience on Early Postoperative Central Corneal Thickness After Cataract Surgery

Cited by 29 publications

References 25 publications

Comparing Resident Outcomes in Cataract Surgery at Different Levels of Experience

Comparing Resident Outcomes in Cataract Surgery at Different Levels of Experience

Comparing Resident Outcomes in Cataract Surgery at Different Levels of Experience: A retrospective case series

Real-Time Extraction of Important Surgical Phases in Cataract Surgery Videos

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