Risk factors for vitreous complications in resident-performed phacoemulsification surgery. 2012

Preston H Blomquist, and Marlene E Morales, and Liyue Tong, and Chul Ahn
Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas 75390-9057, USA. preston.blomquist@utsouthwestern.edu

OBJECTIVE To identify risk factors for intraoperative vitreous complications in resident-performed phacoemulsification surgery. METHODS Two urban public county hospitals. METHODS Case series. METHODS Phacoemulsification cataract surgeries performed by residents between January 4, 2005, and January 8, 2008, were retrospectively reviewed. Clinical characteristics of patients with and without intraoperative vitreous complications were compared and independent factors associated with vitreous complications identified using univariate and multivariate analysis. RESULTS Of 2434 cases meeting inclusion criteria, there were 92 vitreous complications (3.8%). On univariate analysis, significant preoperative risk factors for vitreous complications included older age (P=.020), poor preoperative corrected distance visual acuity (CDVA) (P=.007), left eye (P=.043), history of trauma (P=.045), prior pars plana vitrectomy (P=.034), dementia (P=.020), phacodonesis (P=.014), zonule dehiscence (P<.0001), posterior polar cataract (P=.037), white/mature cataract (P=.005), dense nuclear sclerotic cataract (P=.0006), and poor red reflex (P=.002). Factors that remained significant on multivariate analysis were older age (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.01-1.05), poor preoperative CDVA (OR, 1.52; 95% CI, 1.14-2.03), left eye (OR, 1.63; 95% CI, 1.05-2.51), prior pars plana vitrectomy (OR, 1.88; 95% CI, 1.01-3.51), dementia (OR, 3.65; 95% CI, 1.20-11.17), and zonule dehiscence (OR, 8.55; 95% CI, 3.92-18.63). CONCLUSIONS Elements of the preoperative history and examination can identify patients at higher risk for intraoperative complications during resident-performed phacoemulsification surgery.

UI MeSH Term Description Entries
D007396 Internship and Residency Programs of EDUCATION, MEDICAL, GRADUATE training to meet the requirements established by accrediting authorities. House Staff,Internship, Dental,Residency, Dental,Residency, Medical,Dental Internship,Dental Internships,Dental Residencies,Dental Residency,Internship,Internship, Medical,Internships, Dental,Medical Residencies,Medical Residency,Residencies, Dental,Residencies, Medical,Residency,Residency and Internship,Internships, Medical,Medical Internship,Medical Internships,Residencies,Staff, House
D007431 Intraoperative Complications Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure. Peroperative Complications,Surgical Injuries,Complication, Intraoperative,Complication, Peroperative,Injuries, Surgical,Complications, Intraoperative,Complications, Peroperative,Injury, Surgical,Intraoperative Complication,Peroperative Complication,Surgical Injury
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009885 Ophthalmology A surgical specialty concerned with the structure and function of the eye and the medical and surgical treatment of its defects and diseases. Ocular Surgery,Ocular Surgeries,Surgery, Ocular
D002983 Clinical Competence The capability to perform acceptably those duties directly related to patient care. Clinical Skills,Competence, Clinical,Clinical Competency,Clinical Skill,Competency, Clinical,Skill, Clinical,Skills, Clinical,Clinical Competencies,Competencies, Clinical
D004503 Education, Medical, Graduate Educational programs for medical graduates entering a specialty. They include formal specialty training as well as academic work in the clinical and basic medical sciences, and may lead to board certification or an advanced medical degree. Medical Education, Graduate,Education, Graduate Medical,Graduate Medical Education
D005128 Eye Diseases Diseases affecting the eye. Eye Disorders,Eye Disease,Eye Disorder
D005260 Female Females
D006786 Hospitals, Urban Hospitals located in metropolitan areas. City Hospitals,Hospitals, City,Hospitals, City, Non-Public-Owned,Hospitals, Metropolitan,Urban Hospitals,City Hospitals, Non-Public-Owned,Metropolitan Hospitals,Non-Public-Owned City Hospitals,City Hospital,City Hospital, Non-Public-Owned,City Hospitals, Non Public Owned,Hospital, City,Hospital, Metropolitan,Hospital, Non-Public-Owned City,Hospital, Urban,Hospitals, Non-Public-Owned City,Metropolitan Hospital,Non Public Owned City Hospitals,Non-Public-Owned City Hospital,Urban Hospital

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