Wet Lab–Based Cataract Surgery Training Curriculum for the PGY 2/PGY 3 Ophthalmology Resident

Pantanelli, Seth; Papachristou, G.; Callahan, Christine; Chen, Michael C.; Khalifa, Yousuf M.

doi:10.15766/mep_2374-8265.10782

Cited by 12 publications

(15 citation statements)

References 6 publications

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“…15 Pantanelli et al found that the implementation of a cataract surgery simulation course was correlated with a roughly 62% decrease in intraoperative posterior capsule tear incidence. 19 Similarly, another study assessed differences in cataract surgery complication rates between residents that trained with the Eyesi simulator and residents who did not. Residents who participated in wet lab simulations had significantly lower rates of complications.…”

Section: Discussionmentioning

confidence: 99%

Ophthalmology Resident Ophthalmic Trauma Case Exposure: Trends Over Time and an ACGME Case Log Analysis

Abousy¹,

Schilling²,

Qiu³

et al. 2022

OPTH

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To describe ophthalmology resident experience with ophthalmic trauma cases in the U.S. Methods: We analyzed Accreditation Council for Graduate Medical Education (ACGME) case log data and de-identified case logs from US ophthalmology residency programs for residents graduating in 2018. Current Procedural Terminology (CPT) codes documented as "Globe Trauma" and trauma-related "Oculoplastic and Orbit" codes including lid lacerations and lateral canthotomies were analyzed. Results: 38 residency programs provided case logs (response rate: 32.2%). Residents performed an average of 7.24±4.37 open globe repairs, 8.66±6.94 lid laceration repairs, 0.49±1.4 orbital fracture repairs, 1.22±1.81 lateral canthotomies, and 0.28±0.69 anterior chamber washouts as primary surgeon. On average, the most logged "Globe Trauma" procedure was open globe repair as primary surgeon. The more common trauma-related "Oculoplastic and Orbit" procedure was lid laceration repair as primary surgeon. 42.8% of residents did not log any lateral canthotomy procedures. Medium programs performed significantly more canthotomies than large programs (F(2166) = 6.35, p = 0.002), and large programs performed significantly more orbital fracture repairs than small and medium programs (F(2166) = 4.45, p = 0.013). Conclusion: Significant variation in globe trauma volume exists across programs. ACGME guidelines require a minimum of four globe trauma procedures for graduation, but procedures like anterior chamber paracentesis count towards this requirement. Open globe repairs, simple lid lacerations, and lateral canthotomies are basic skills every graduating resident should be competent in. Updating ACGME case log requirements for ophthalmic trauma and increasing opportunities for wet lab simulations may assist in ensuring graduating ophthalmology residents' competency in performing these procedures.

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Section: Discussionmentioning

confidence: 99%

Ophthalmology Resident Ophthalmic Trauma Case Exposure: Trends Over Time and an ACGME Case Log Analysis

Abousy¹,

Schilling²,

Qiu³

et al. 2022

OPTH

View full text Add to dashboard Cite

show abstract

“…The authors further propose targeting wet lab and cadaver practice toward procedures that are infrequently logged, as prior literature has demonstrated the positive effect of simulations on resident confidence and surgical skill level. [18][19][20] For example, canthal procedures and TA biopsy could be emphasized in these supplemental practice opportunities given their usefulness in addressing acute, vision-threatening pathologies. Solely increasing case log requirements will likely be insufficient to ensure resident competency in these foundational oculofacial surgery skills.…”

Section: Discussionmentioning

confidence: 99%

Ophthalmology Resident Oculofacial Surgery Case Exposure: An ACGME Case Log Analysis

Abousy

Schilling

Qiu

et al. 2022

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: The authors quantified trends in resident oculofacial surgery exposure between 2009 and 2018, reviewed specific procedure volume, and correlated procedure volume with program characteristics. Methods: The authors requested de-identified case logs of residents graduating US ophthalmology residency programs in 2018 from all 118 programs. Current Procedural Terminology codes of all oculofacial procedures were analyzed. Current Procedural Terminology codes were grouped into 25 unique categories that the authors created in addition to the 11 Accreditation Council for Graduate Medical Education categories. Results: One hundred and sixty-six of 488 (34%) US ophthalmology residents graduating in 2018 provided case logs (32.2% of programs). According to Accreditation Council for Graduate Medical Education case logs, residents graduating in 2018 completed significantly fewer eye removal/implant procedures, lacrimal surgeries, “other orbital” procedures, entropion/ectropion repairs, and temporal artery biopsies as primary surgeon than residents graduating in 2009, yet significantly more eyelid laceration repairs, chalazion excisions, tarsorrhaphies, ptosis repairs, and blepharoplasty/reconstruction procedures (p < 0.05). No difference was found between the total number of oculofacial cases between 2009 and 2018 (p = 0.051). The most frequently logged procedure per resident in the sample was blepharoplasty/reconstruction (17.2 ± 15) followed by “other oculoplastic” (12.7 ± 10.6). The least commonly performed procedures included temporal artery biopsy (1.5 ± 2.2) and “other orbital” (1.9 ± 3.1). Program size, location, and presence of oculofacial fellowship program all impacted case volume. Conclusions: Oculofacial surgery has the second highest case number requirement for residents per Accreditation Council for Graduate Medical Education guidelines. However, resident exposure to oculofacial surgery cases greatly varies in each ophthalmology residency program.

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“… 7 8 9 10 11 12 A study performed at The Pennsylvania State University showed a reduction of PCR rate to 1.13% following the implementation of a wet laboratory curriculum, although this was a smaller postcurriculum cohort of 2,044 cases that took place over the course of 3 academic years. 13 …”

Section: Discussionmentioning

confidence: 99%

Rate of Posterior Capsule Rupture in Phacoemulsification Cataract Surgery by Residents with Institution of a Wet Laboratory Course

Jeang

Liechty

Powell

et al. 2022

Journal of Academic Ophthalmology

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Purpose To determine if a structured surgical wet laboratory curriculum for ophthalmology residents reduced the rate of posterior capsule rupture (PCR) in phacoemulsification cataract surgery. Setting James A. Haley Veterans' Hospital, Tampa, FL. Design Retrospective cohort study. Methods The study assessed resident-performed phacoemulsification cataract cases from 2011 to 2017, after the creation of a wet laboratory course. Primary outcome measure was PCR. If present, timing of complication, dropped lens fragments, and the need for anterior vitrectomies were noted. Self-reported rates of PCR prior to institution of a wet laboratory course (2010–2011) were compared with cases done by residents who completed the course (2011–2017). Results A total of 3,445 cases were reviewed of which 2.44% (84 cases) noted PCR. Of these, 19% (16) had dropped lens fragments, and 60.7% (51) required anterior vitrectomy. Sixty-nine cases documented timing of PCR with the majority, 58%, occurring during phacoemulsification. When comparing rates of PCR in cases done prior to the presence of a wet laboratory course versus after, there was a significant reduction observed (5.20% before vs. 2.44% after). Conclusion In the presence of a wet laboratory curriculum, the rate of PCR decreased dramatically. The average rate was lower than those reported at other training programs (2.6–9.9%). Most PCR occurred during phacoemulsification, suggesting need for further focused instruction in this step.

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Wet Lab–Based Cataract Surgery Training Curriculum for the PGY 2/PGY 3 Ophthalmology Resident

Cited by 12 publications

References 6 publications

Ophthalmology Resident Ophthalmic Trauma Case Exposure: Trends Over Time and an ACGME Case Log Analysis

Ophthalmology Resident Ophthalmic Trauma Case Exposure: Trends Over Time and an ACGME Case Log Analysis

Ophthalmology Resident Oculofacial Surgery Case Exposure: An ACGME Case Log Analysis

Rate of Posterior Capsule Rupture in Phacoemulsification Cataract Surgery by Residents with Institution of a Wet Laboratory Course

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