Practice patterns of cataract surgeons at academic medical centers for the management of inadequate capsule support for intracapsular or sulcus intraocular lens placement during cataract surgery

Rebecca Sorenson, Ingrid Scott, Steven H. Tucker, Vernon Chinchilli, George Papachristou

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose To determine practice patterns with regard to intraocular lens (IOL) placement during cataract surgery when there is inadequate capsule support for intracapsular or sulcus IOL placement. Setting Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA. Design Cross-sectional study of anonymous survey results. Methods An online survey was e-mailed to the coordinators of all Accreditation Council for Graduate Medical Education-accredited ophthalmology residency programs with a request to forward to all faculty who perform cataract surgery. Results Sixty-seven (57.2%) of 117 confirmed survey recipients participated. Thirty-six (62.1%) said they felt comfortable placing scleral-fixated posterior chamber IOLs (PC IOLs) independently. Faced with inadequate capsule support, 58.6% would place a primary anterior chamber IOL (AC IOL), 29.3% would place a primary scleral-fixated PC IOL, and 5.3% would leave the patient aphakic for secondary scleral-fixated PC IOL placement. Surgeons not comfortable placing scleral-fixated PC IOLs were most likely to choose primary AC IOLs (77.3%). Surgeons comfortable placing scleral-fixated PC IOLs were more evenly divided between primary AC IOLs (47.2%) and scleral-fixated PC IOLs (41.7%). Among surgeons who favored primary scleral-fixated PC IOLs, 63.7% cited a decreased risk for long-term complications as their reason for IOL choice; 50.0% of surgeons who favored primary AC IOLs cited avoidance of a second surgery. Conclusions In general, primary AC IOL placement was preferred in the setting of inadequate capsule support, although less so among surgeons who were comfortable placing scleral-fixated PC IOLs. Lack of comfort with scleral-fixated PC IOL placement suggests a potential unmet training need in residency and fellowship programs. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.

Original languageEnglish (US)
Pages (from-to)239-245
Number of pages7
JournalJournal of Cataract and Refractive Surgery
Volume42
Issue number2
DOIs
StatePublished - Feb 1 2016

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Intraocular Lenses
Cataract
Capsules
Anterior Chamber
Internship and Residency
State Medicine
Graduate Medical Education
Accreditation
Disclosure
Ophthalmology
Cross-Sectional Studies
Surgeons
Surveys and Questionnaires

All Science Journal Classification (ASJC) codes

  • Surgery
  • Ophthalmology
  • Sensory Systems

Cite this

@article{67e0b855daa64535a9f10d1e02e5cbfa,
title = "Practice patterns of cataract surgeons at academic medical centers for the management of inadequate capsule support for intracapsular or sulcus intraocular lens placement during cataract surgery",
abstract = "Purpose To determine practice patterns with regard to intraocular lens (IOL) placement during cataract surgery when there is inadequate capsule support for intracapsular or sulcus IOL placement. Setting Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA. Design Cross-sectional study of anonymous survey results. Methods An online survey was e-mailed to the coordinators of all Accreditation Council for Graduate Medical Education-accredited ophthalmology residency programs with a request to forward to all faculty who perform cataract surgery. Results Sixty-seven (57.2{\%}) of 117 confirmed survey recipients participated. Thirty-six (62.1{\%}) said they felt comfortable placing scleral-fixated posterior chamber IOLs (PC IOLs) independently. Faced with inadequate capsule support, 58.6{\%} would place a primary anterior chamber IOL (AC IOL), 29.3{\%} would place a primary scleral-fixated PC IOL, and 5.3{\%} would leave the patient aphakic for secondary scleral-fixated PC IOL placement. Surgeons not comfortable placing scleral-fixated PC IOLs were most likely to choose primary AC IOLs (77.3{\%}). Surgeons comfortable placing scleral-fixated PC IOLs were more evenly divided between primary AC IOLs (47.2{\%}) and scleral-fixated PC IOLs (41.7{\%}). Among surgeons who favored primary scleral-fixated PC IOLs, 63.7{\%} cited a decreased risk for long-term complications as their reason for IOL choice; 50.0{\%} of surgeons who favored primary AC IOLs cited avoidance of a second surgery. Conclusions In general, primary AC IOL placement was preferred in the setting of inadequate capsule support, although less so among surgeons who were comfortable placing scleral-fixated PC IOLs. Lack of comfort with scleral-fixated PC IOL placement suggests a potential unmet training need in residency and fellowship programs. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.",
author = "Rebecca Sorenson and Ingrid Scott and Tucker, {Steven H.} and Vernon Chinchilli and George Papachristou",
year = "2016",
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doi = "10.1016/j.jcrs.2015.09.022",
language = "English (US)",
volume = "42",
pages = "239--245",
journal = "Journal of Cataract and Refractive Surgery",
issn = "0886-3350",
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T1 - Practice patterns of cataract surgeons at academic medical centers for the management of inadequate capsule support for intracapsular or sulcus intraocular lens placement during cataract surgery

AU - Sorenson, Rebecca

AU - Scott, Ingrid

AU - Tucker, Steven H.

AU - Chinchilli, Vernon

AU - Papachristou, George

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Purpose To determine practice patterns with regard to intraocular lens (IOL) placement during cataract surgery when there is inadequate capsule support for intracapsular or sulcus IOL placement. Setting Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA. Design Cross-sectional study of anonymous survey results. Methods An online survey was e-mailed to the coordinators of all Accreditation Council for Graduate Medical Education-accredited ophthalmology residency programs with a request to forward to all faculty who perform cataract surgery. Results Sixty-seven (57.2%) of 117 confirmed survey recipients participated. Thirty-six (62.1%) said they felt comfortable placing scleral-fixated posterior chamber IOLs (PC IOLs) independently. Faced with inadequate capsule support, 58.6% would place a primary anterior chamber IOL (AC IOL), 29.3% would place a primary scleral-fixated PC IOL, and 5.3% would leave the patient aphakic for secondary scleral-fixated PC IOL placement. Surgeons not comfortable placing scleral-fixated PC IOLs were most likely to choose primary AC IOLs (77.3%). Surgeons comfortable placing scleral-fixated PC IOLs were more evenly divided between primary AC IOLs (47.2%) and scleral-fixated PC IOLs (41.7%). Among surgeons who favored primary scleral-fixated PC IOLs, 63.7% cited a decreased risk for long-term complications as their reason for IOL choice; 50.0% of surgeons who favored primary AC IOLs cited avoidance of a second surgery. Conclusions In general, primary AC IOL placement was preferred in the setting of inadequate capsule support, although less so among surgeons who were comfortable placing scleral-fixated PC IOLs. Lack of comfort with scleral-fixated PC IOL placement suggests a potential unmet training need in residency and fellowship programs. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.

AB - Purpose To determine practice patterns with regard to intraocular lens (IOL) placement during cataract surgery when there is inadequate capsule support for intracapsular or sulcus IOL placement. Setting Pennsylvania State College of Medicine, Hershey, Pennsylvania, USA. Design Cross-sectional study of anonymous survey results. Methods An online survey was e-mailed to the coordinators of all Accreditation Council for Graduate Medical Education-accredited ophthalmology residency programs with a request to forward to all faculty who perform cataract surgery. Results Sixty-seven (57.2%) of 117 confirmed survey recipients participated. Thirty-six (62.1%) said they felt comfortable placing scleral-fixated posterior chamber IOLs (PC IOLs) independently. Faced with inadequate capsule support, 58.6% would place a primary anterior chamber IOL (AC IOL), 29.3% would place a primary scleral-fixated PC IOL, and 5.3% would leave the patient aphakic for secondary scleral-fixated PC IOL placement. Surgeons not comfortable placing scleral-fixated PC IOLs were most likely to choose primary AC IOLs (77.3%). Surgeons comfortable placing scleral-fixated PC IOLs were more evenly divided between primary AC IOLs (47.2%) and scleral-fixated PC IOLs (41.7%). Among surgeons who favored primary scleral-fixated PC IOLs, 63.7% cited a decreased risk for long-term complications as their reason for IOL choice; 50.0% of surgeons who favored primary AC IOLs cited avoidance of a second surgery. Conclusions In general, primary AC IOL placement was preferred in the setting of inadequate capsule support, although less so among surgeons who were comfortable placing scleral-fixated PC IOLs. Lack of comfort with scleral-fixated PC IOL placement suggests a potential unmet training need in residency and fellowship programs. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.

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