Surgical outcomes, complications and learning curve of glued intraocular lens of a vitreo retinal fellow in training

Purpose: To evaluate surgical outcomes, complications and learning curve of glued intraocular lens surgery by a vitreoretinal (VR) fellow in training. Methods: Analysis of 50 eyes requiring glued intraocular lens (GIOL) surgery for various indications was done. Both the consultant VR surgeon (Group 1) and VR fellow in training (Group 2) operated 25 eyes each. The primary outcome measures were visual acuity at 3 months, and time taken for completion of surgery. Secondary outcome measures were refractive correction, intraocular pressure and intraoperative or postoperative complications. Results: The uncorrected visual acuity (UCVA) improved from log MAR 1.54�56 (Snellen 20/693) to 0.45�26 (Snellen 20/56) and from 1.64�53 (Snellen 20/873) to 0.56�45 (Snellen 20/72) in group 1 and 2, respectively. The best corrected visual acuity (BCVA) improved from log MAR 0.74�61 (Snellen 20/109) to 0.33�26 (Snellen 20/42) and from 1�68 (Snellen 20/200) to 0.40�50 (Snellen 20/50) in group 1 and 2, respectively (P > 0.05). The surgical time was significantly less in group 1 when compared to that of group 2 (64.26 vs 107.16 minutes) P value <0.05). The mean time taken for the initial 10 cases and later 15 cases in group 2 were 131.9 and 91.2 minutes, which was statistically significant. The complication rates in both groups were comparable. Transient hypotony (IOP < 11) was seen in 56% (14/25) of eyes in group 2 and 44% (11/25) in group 1 (P = 0.39). Conclusion: The study results are encouraging for a VR fellow with good short-term visual outcomes and comparable surgical complications. The procedure gives promising results and the learning curve is overcome by a desire to learn and with increasing number of procedures done under supervision.