Seasoned cataract surgeons late in their career still perform a significant amount of surgeries with a low level of complications when compared to their younger colleagues, according to a study in JAMA Ophthalmology.

A team of Canadian researchers investigated whether an increase in cataract surgical adverse events occurred during the later surgeon career stage in this large, population-based study of 499,650 cataract operations performed in Ontario between 2009 and 2013. The investigators looked for the following complications: dropped lens fragments, posterior capsule rupture, suspected endophthalmitis and retinal detachment.

During the study period, late-career surgeons performed 143,108 cataract operations (28.6%). Researchers found surgeons in the latter part of their careers did not have an overall increased risk of complications vs. mid-career surgeons; the odds ratio (OR) was 1.06. When surgeon volume was removed from the study model, late career stage doctors were still not associated with overall adverse surgical events (OR 1.10). 

Among individual complications, researchers reported surgeons at the later part of their careers were associated with an increased risk of dropped lens fragment (OR 2.30 and suspected endophthalmitis (OR 1.41. The researchers noted these numbers corresponded with small absolute risk differences of 0.11% and 0.045% for dropped lens fragment and suspected endophthalmitis, respectively.

“These findings suggest that later-career surgeons are performing a substantial proportion of cataract operations with overall low surgical adverse event rates,” the researchers said in their publication. “Future studies might extend evaluations to the frequency of secondary surgical interventions as additional measures of surgical care quality.”

Campbell RJ, El-Defrawy SR, Gill SS, et al. Association of cataract surgical outcomes with late surgeon career stages: a population-based cohort study. JAMA Ophthalmol. Oct. 11, 2018 (E-pub, ahead of print).