Advanced cataract learning experience in United States ophthalmology residency programs

This study examined resident exposure to and competency in new techniques for cataract removal and intraocular lens (IOL) implantation. A questionnaire was sent to 116 United States ophthalmology program directors and completed by 71. In response to the questionnaire, program directors reported that 95.3% of their graduating seniors were competent to select and implant toric IOLs and 52.3% were competent to implant capsular tension rings (CTRs). Divide and conquer (56.6%) and stop and chop (25.4%) dominated phacoemulsification teaching. Femtosecond laser–assisted cataract surgery was performed by residents in 44.1% of programs. In 25.4%, residents observed but did not perform the procedure; in 35.6%, they received didactic-only training; and in 22.0%, they received no exposure. Most programs (73.2%) had virtual-reality simulators for cataract surgery, but wet-lab practice (91.1%), didactic training (82.1%), and watching videos (82.1%) were the primary curricular tools used to teach advanced technologies.