Comparison of trainee versus consultant outcomes in immediate sequential bilateral cataract surgery in the UK: A two-armed cohort study.

Purpose: To compare the outcomes of Immediate Sequential Bilateral Cataract Surgeries (ISBCS) performed by trainees versus consultant ophthalmologists at Moorfields Eye Hospital and its satellite centres. Methods: Reviewed ISBCS surgeries by phacoemulsification and intraocular lens implant performed by trainee ophthalmologists (Gr1) and consultant ophthalmologists (Gr2). Studied complications, refraction outcome (spherical equivalent SE > 0.5D and > 1.0D), and uncorrected distance visual acuity (UDVA logMAR) at 3 months post-ISBCS. Results 553 eyes in Gr1 and 687 in Gr2. Intra and postoperative complications were similar between trainees and consultants [RR = 1.88 (95% CI 0.8; 4.2) P = 0.13]. Median SE in Gr1 [-0.12 D (IQR − 0.5; -0.25)] and Gr2 [-0.25D (IQR − 0.63; -0.13)] showed no significant difference (MW P = 0.08). Predicted median PCR risk was higher in Gr1 [1.54 (IQR 1.04; 2.16)] than in Gr2 [1.16 (IQR − 0.84; 1.7)] (MW P < 0.001). Postoperative SE > 0.5D occurred in 19.2% of Gr1 and 15.7% of Gr2 (P = 0.123). Postoperative SE > 1.0D occurred in 6% of Gr1 and 3.9% of Gr2 (P = 0.142). UDVA post-surgery was similar in both groups (MW P = 0.26). Surgeon type, PCR risk, and predicted refraction were not significant predictors of postoperative SE > 0.5D. Conclusions ISBCS outcomes by trainee ophthalmologists were similar to those by consultants. Higher PCR risk in eyes operated by trainees suggests the need for more supervised training.