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Incidence, characteristics, outcomes and confidence in managing posterior capsular rupture during cataract surgery in the UK: an ophthalmology trainees’ perspective

Lookup NU author(s): Professor David SteelORCiD



This is the authors' accepted manuscript of an article that has been published in its final definitive form by Springer Nature, 2021.

For re-use rights please refer to the publisher's terms and conditions.


© 2020, The Author(s), under exclusive licence to The Royal College of Ophthalmologists. Purpose: To examine the incidence, characteristics and outcomes of posterior capsular rupture (PCR) cases amongst the ophthalmology trainees and to evaluate the trainees’ confidence in managing PCR. Methods: A two-staged cross-sectional study was carried out between September 2017 and April 2018 in the North East of England, UK. All ophthalmology trainees were surveyed on their confidence level in managing PCR and the characteristics and outcomes of their PCR cases. Results: Fifteen (71.4%) out of 21 trainees completed the study. The mean number of phacoemulsification was 268.9 ± 250.9 cases (range, 0–705) per trainee. There were 82 (1.9%) cases of PCR reported among 4303 phacoemulsification. PCR occurred most commonly during quadrant removal (44.0%) and cortex removal (21.3%). The best-corrected visual acuity (in logMAR) improved significantly from 0.47 ± 0.32 preoperatively to 0.20 ± 0.19 postoperatively (p < 0.001). The supervising consultant took over 80.5% of the PCR cases. The PCR rate decreased significantly from 3.1% at 0–100 cases to 0.6% at 301–400 cases (p = 0.004) and to 0.4% at >500 cases (p = 0.005). Confidence in managing PCR (without supervision) improved from 0% (9/9) at junior level to 50% (3/6) at senior level, and the average number of anterior vitrectomies performed was 0.6 ± 0.9 (range: 0.0–2.0). Conclusions: We observed a low PCR rate among the trainees in our region, with the majority of cases achieving good visual outcome. A significant reduction in PCR rate was observed at the threshold of >500 cases. There is however a lack of confidence among trainees in managing PCR, highlighting the need for devising new training strategies in this area.

Publication metadata

Author(s): Grinton M, Sandhu J, Shwe-Tin A, Steel DHW, Ting DSJ, Bommireddy T, Cheema MR, Chen Y, Chen Y, Cunningham A, El-Assal K, Hill E, Ismail R, Hogg J, Kishikova L, Lunt DL, Madi H, Markham M, Masri I, Ting E, Vrahimi M, Wu C

Publication type: Article

Publication status: Published

Journal: Eye

Year: 2021

Volume: 35

Pages: 1213-1220

Print publication date: 01/04/2021

Online publication date: 01/07/2020

Acceptance date: 18/06/2020

Date deposited: 26/08/2020

ISSN (print): 0950-222X

ISSN (electronic): 1476-5454

Publisher: Springer Nature


DOI: 10.1038/s41433-020-1057-z


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