Vitreous Loss During Phacoemulsification Learning Curve Performed by Third-Year Residents
Pakitti Tayanithi MD*, Keerati Pungpapong MD*, Patharaporn Siramput MD*
Affiliation : * Department of Ophthalmology, Chulalongkorn University and Hospital
Objectives : To assess the residentûs phacoemulsification learning curve as a risk factor for vitreous loss and to
determine the incidence of vitreous loss among the residents performing phacoemulsification.
Design : Retrospective matched case-control study
Materials and Methods : A case-control study comparing all consecutive cases of attempted phacoemulsification
with intraocular lens (IOL) implantation from January 1st, 1998 to December 31st, 1999. The surgeon variable
will be categorized into two groups, the third year ophthalmology residents, representing residentûs
phacoemulsification learning curve, and faculty staffs. The study group consisted of eyes that had had intra-
operative complication of vitreous loss. The control group consisted of eyes that had not had vitreous loss.
Continuous variables were compared with the 2-sided unpaired t-test. Categorical variables were compared
between groups using analytical matched case-control study with relative risk or odd ratio, Mc Nemarûs
(Marginal) o^ 2 test and 95% confident interval of relative risk.
Results : The odds that the eyes in the resident group would have an intraoperative complication of vitreous loss
were 4 times the odds that the eyes in the faculty staff group would have such complication (P = 0.0052, 95%
confidential interval (CI) of relative risk (RR) = 1.516-10.556). The incidence of vitreous loss among residents
was 6.93% (28/404) and 2.06% (28/1358) among the faculty staffs. The overall incidence of vitreous loss was
3.18% (56/1762).
Conclusion : The incidence of intraoperative complication of vitreous loss, the relative risk of such complica-
tion performed by the learning curve surgeon in the present study serve as benchmarks for residents-in-
training, beginning and surgeon-in-practice converting to phacoemulsification.
Keywords : Vitreous loss, Phacoemulsification learning curve, Resident
