The surgical improvement profile of the residents in phacoemulsification training period

SUMMARY Phacoemulsification has become the basic method in cataract surgery with its increasing popularity day by day. This yielded the result of obligatory phacoemulsification training in institutions providing ophthalmology education. The aim of this study was to find out some parameters in cataract surgery training and to identify both the role of human factor and the profile of gaining skills and experience in this education period. The patients with the indication of cataract surgery, underwent operation by a resident who was ordered and observed by the instructor for the relevant day. The group of patients who underwent cataract surgery by the senior surgeons in the same period were taken as the control group. The patients were analyzed in three groups. The first one was the control group. The second group was the patients operated by the third year residents and the third group was the ones operated by the second year residents. It was found that the first group had denser nuclei and fewer capsulotomy problems compared to other groups. Uncontrolled capsulorhexis and posterior capsule rupture were more common in second year residents. The rate of vitreous loss was significantly higher in the second group compared to other groups. In the second and third groups, by whom the operation was completed were noted. When compared according to the ability to complete the operation by themselves, there was a significant difference between two groups with a higher rate in the second group. It was seen that certain criteria such as pupil dilatation, PE and nucleus density should be taken into consideration when choosing training cases for the residents. Incision problems were more frequent in the second group. More practice on incision techniques is recommended in residency tiaining. Uncontrolled capsulorhexis which seems to improve by experience, is an important problem in our clinic when compared to the other reported cases. It is thought that the residents should practice more on capsulorhexis on animal models. The rate of the posterior capsule rupture was estimated to be higher in the third group. Since it is in the tendency of decreasing as the experience increases, it is thought 67that second year residents should start surgery after gaining more knowledge and experience on the subject. The rate of vitreous loss was higher in the third group, however it might be considered low according to the high rate of posterior capsule rupture in that group. It is estimated to be related to good timing of the instructor to take the precautions before the vitreous appears. The third year residents could be assessed successful in this subject. As a matter of fact, the second year residents took more assistance during the surgery than the third year residents. In order to decrease the rate of complication, the instructor should assist the training residents during the surgery. The assistance rate decreases by time, as the residents gain more experience. 68