Phacoemulsification: A trainee's perspective

Background: Phacoemulsification is the main stay of cataract extraction surgery in the developed world as well as it is becoming increasingly popular in the developing nations as well. However, this technique is not widely incorporated in the residency training program in many developing nations. Objective: This study was conducted to evaluate the visual outcomes and complications of phacoemulsification surgery performed by a trainee surgeon. Methods: A prospective, cross-sectional study was performed in the tertiary eye hospital of eastern Nepal. All the consecutive cases of phacoemulsification surgery were included which was performed by a trainee surgeon with previous exposure of conventional extra-capsular cataract surgery and competency in sutureless manual small incision cataract surgery. The technique implied for nuclear division was stop and chop method. The visual outcomes and the complications of the surgery were evaluated. Results: A total of 200 eyes of 200 patients were included. The patients were followed up for 12 weeks. The mean age of the patients was 57.8 ± 9.8 years. The average effective phacoemulsification time (EPT) was 21.6 ± 15.8 seconds. The incidence of intra-operative complication of posterior capsular rupture with vitreous loss was 6/200 (3%). Striate keratopathy was present in (6.5%) of the cases in the first post-operative day. At the final examination, improvement in vision by 6/12 or better was observed in 183 (91.5%) eyes. Conclusion: Improvement in surgical teachings, good orientation to manual cataract extraction, careful selection of early cases and staffed supervision will lead to safe and easy transition to phacoemulsification surgery