Statistical evaluation of intraoperative and postoperative complications occurring during learning curve of various techniques of cataract surgery at a teaching hospital in north Karnataka


  • Sumeet Deshpande Department of Ophthalmology, MRMC, Kalaburgi, Karnataka, India
  • Sarita S. Deshpande Department of Ophthalmology, MRMC, Kalaburgi, Karnataka, India
  • Rajashree Reddy Department of Ophthalmology, MRMC, Kalaburgi, Karnataka, India
  • Vishwanath Reddy Department of Ophthalmology, MRMC, Kalaburgi, Karnataka, India



Evaluation, Complications, Cataract, Surgeons


Background: Aim of cataract surgery is, no longer restricted just to visual restoration, but is now considered to be a Refractive surgery i.e. to achieve state of emmetropia. The surgical technique has revolutionized rapidly from Intracapsular cataract extraction to Extra-capsular cataract extraction, from sutured surgery to sutureless cataract extraction to most advanced technique of Phacoemulsification. Adopting a new technique requires development of skill that differ from previous experience.

Methods: This was a prospective study carried out at MR Medical College, Gulbarga from November 2012 to August 2014. The surgeons were categorized in three groups. The patients included in the study were equally distributed amongst the surgeons by purposive random sampling technique. All the surgeries were performed under microscope with the use of viscoelastics manufactured by same company. The surgeries were performed under the supervision of trainer, who guided or took over the case, whenever it was required. The intra-operative and post-operative findings were noted and they were statistically analysed by using various statistical tests.

Results: A total of 270 patients out of which 123 (45.55%) were males and 147 (54.44%) females Overall intraocular complication in the study was seen in 33 eyes, maximum was posterior capsular rent seen in 19 cases. Among post-operative findings corneal edema was in 133 cases. Statistical analysis of the study showed that there is significant difference regarding post-operative complications.

Conclusions: Rate of complications was seen higher with learning of non-phaco SICS. If a surgeon is well versed with tunnel making and CCC the learning curve for phacoemulsification can be reduced. Immediate visual restoration was better in eyes that underwent phacoemulsification, though they were operated by training surgeons.


Hardten. Corneal complications of cataract extraction and IOL implantation. Current opinion in ophthalmology. 1993;4(4):99-105.

Thomas R, Braganza A, Raju R, Lawrence G, Spitzer K. Phacoemulsification: a senior surgeon's learning curve. Ophthalmic Surg. 1994;8:504-9.

Blomquist PH, Rugwani RM. Visual outcome after vitreous loss during cataract surgery performed by residents. J Cataract Refract Surg. 2002;28(5):847-52

Kothari M, Thomas R, Parikh R, Braganza A, Kuriakose T, Muliyil J. The incidence of vitreous loss and visual outcome in patients undergoing cataract surgery in a teaching Hospital. IJO. 2003;51(1):45-52

Fernandez ST, Pious S, Moniz N. Endocapsular insertion of intra ocular implant. IJO. 1989;37(2):75-7.

Desai P, Minassian DC, Reidy A. National cataract surgery survey 1997-98: a report of the results of the clinical outcomes. Br J Ophthalmol. 1999;83:1336-40.

Alhassan MB, Kyari F, Achi IB, Ozemela CP. Audit of outcome of extracapsular cataract extraction and posterior chamber intraocular lens training course. Br J Ophthalmol. 2000;84:848-51.

Chew A. The value of auditing the results of cataract surgery. Experience at Galmi Hospital, Niger. Comm Eye Health. 1996;9(18):28-30.

Browning DJ, Cobo LM. Early experience in extracapsular surgery by residents. Ophthalmol.1985;92(12):1647-53.

Bhel S, Mudras R, Shah J, Shah M, Shah K. Phaco training -a learning experience. J Bombay Ophth Association. 2001;11(3):84-5.

Sudhakar J, Ravidran RD, Natchiar G. Analysis of complications in 1000 cases of posterior chamber intraocular implantation. IJO. 1989;37(2):78-9.

Tabandeh H, Smeets B, Teimory M, Seward H. Learning phaco-emulsification: the surgeon in training. Eye (Lond.). 1994;8(pt 4):475-7.






Original Research Articles