Journal of Ophthalmic and Vision Research

Published date: Jul 21 2025

Journal Title: Journal of Ophthalmic and Vision Research

Issue title: ‎Volume 20 - 2025

Pages: 1 - 8

DOI: 10.18502/jovr.v20.14823

Hossein Mohammad-Rabeih.mohammadrabei@gmail.comOphthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran

Homayoun Nikkhahh.nikkhah52@gmail.comOphthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran

Zhale Rajavizhalerajavi@gmail.comOphthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran

Mohammadmehdi Hatamidrmehdihatami@gmail.comOphthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran

Mohammadsadegh Haghparastmohammadsadeghhaghparast@gmail.comOphthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran

Hamed Esfandiarihmdesfandiary@gmail.comDepartment of Ophthalmology, Olmsted Medical Center, Rochester, Minnesota

Purpose: To investigate the incidence and risk factors of intraoperative complications during phacoemulsification surgery performed by ophthalmology residents at an academic training center.
Methods: This comparative case series included 1121 eyes of 821 patients that underwent phacoemulsification cataract surgery by ophthalmology residents from March 2020 to March 2021. Patients’ medical records were reviewed for demographics, systemic and ophthalmic comorbidities, biometric data, surgical details, anesthesia type, residents’ training year, and the occurrence of any intraoperative complications. Multivariate models were used to identify potential risk factors for intraoperative complications.
Results: Intraoperative complications were observed in 63 eyes (5.6%). From the most to the least frequent, they included posterior capsular rupture with vitreous loss in 29 eyes (2.6%), anterior capsular tear in 21 eyes (1.9%), nucleus drop in 8 eyes (0.7%), zonular dehiscence in 3 eyes (0.3%), and posterior capsular rupture without vitreous loss in 2 eyes (0.2%). On univariate analysis, mature or brunescent cataracts (OR = 3.096, P = 0.031), residents’ training year (OR = 2.238, P = 0.017), and pseudoexfoliation (OR = 2.247, P = 0.049) were associated with vitreous loss. Multivariate data analysis indicated that mature or brunescent cataracts (OR = 4.046, P = 0.009) and residents’ training year (OR = 3.238, P = 0.005) were independent risk factors for vitreous loss.
Conclusion: We observed a higher rate of intraoperative complications in eyes with mature or brunescent cataracts or in procedures performed by less experienced residents. Proper case selection and direct attending supervision are crucial in preventing intraoperative complications at ophthalmology training centers.

Keywords: Intraoperative Complication, Phacoemulsification, Posterior Capsular Rupture, Resident Training Level, Vitreous Loss

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