Cataract surgery is one of the most commonly performed surgical procedures carried out worldwide but there is a steep learning curve and a higher complication rate for trainee surgeons. This study reports on an innovative training programme of combining the use of surgical simulation followed by an ‘intensive’ period of cataract surgical training, with daily theatre lists. The intensive period in a tertiary centre was followed by a consolidation period in a district general hospital. The training programme begins with wet lab and virtual reality simulation, with trainees completing about 50 hours of structured modules on the simulator. All cases were videoed and complications reported and reviewed with the training programme director. The mean number of theatre sessions required to complete 150 cases was 84. Interestingly, the number of surgical complications was low, with a posterior capsule rupture rate of less than 1%. The authors comment that cataract surgery remains one of the most challenging procedures to master in ophthalmology training and the outcomes are being subjected to increased scrutiny. It is therefore essential to provide good training without compromising patient safety. This pilot shows that intensive surgical training can achieve this, although the challenge now will be to incorporate this as standard, bearing in mind the other factors that ophthalmology services are facing at the moment in combining a service commitment, with the requirements of training.

Intensive cataract training: a novel approach.
Baxter JM, Lee R, Sharp JAH, Foss AJE.
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John Brookes

Moorfields Eye Hospital, London, UK.

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