# Impact of surgeon experience on corneal endothelial changes after cataract surgery

## TL;DR

This study found that less experienced surgeons cause more corneal cell loss after cataract surgery, suggesting a need for improved training protocols.

## Contribution

The study quantifies the impact of surgeon experience on corneal endothelial changes after cataract surgery.

## Key findings

- Less experienced surgeons showed a significant reduction in central endothelial cell density.
- Grade II cataracts showed significant variations in endothelial cell density and size with less experienced surgeons.
- Visual acuity and endothelial indices varied significantly between surgeon experience levels.

## Abstract

To compare endothelial corneal cell changes following cataract surgery
performed by phacoemulsification with intraocular lens implantation,
conducted by surgeons with varying levels of experience.

Two hundred and eighty-three eyes diagnosed with cataract were included. Lens
opacity was classified into three categories (I, II, and III). Surgeons were
categorized into four experience levels (1, 2, 3, and 4), based on years of
practice and lifetime surgeries performed. Corneal endothelial
characteristics were assessed using non-contact specular microscopy, with
measurements taken before surgery and 30-60 days post-surgery.

Preand postoperative endothelial analysis showed no significant differences
between surgeon levels regarding visual acuity achieved, corneal thickness,
and endothelial hexagonality. However, the central endothelial cell density
index showed a significantly greater reduction among level 1 surgeons
(p=0.026). Grade II cataracts exhibited significant variations in the
central endothelial cell density (p=0.011) and average cell size, with level
1 surgeons showing the largest increases (p=0.024).

The analysis revealed significant differences in visual acuity and
endothelial indices between surgeon experience levels, with less experienced
surgeons showing greater variations and poorer performance. Clinical
protocols should consider these data to establish safer training
protocols.