Clinical Study
Eye (2008) 22, 55–59; doi:10.1038/sj.eye.6702512; published online 14 July 2006
'Fast-track' cataract services and diagnostic and treatment centre: impact on surgical training
This study has been accepted for a poster presentation in the Royal College of Ophthalmologist Congress 2006
L Au1, K Saha1, B Fernando1, S Ataullah1 and F Spencer1
1Manchester Royal Eye Hospital, Manchester, UK
Correspondence: L Au, Manchester Royal Eye Hospital, Oxford Road, Manchester M13 9WH, UK. Tel: +44 161 276 1234; E-mail: auleon@aol.com
Received 17 March 2006; Accepted 8 June 2006; Published online 14 July 2006.
Abstract
Aims
To evaluate the impact of 'Action on Cataracts' and the development of Diagnostic and Treatment Centre (DTC) on cataract surgery training in the Central Manchester and Manchester Children's University Hospital's Trust.
Methods
We compared all cataract extractions undertaken from April to September 2005 with the same 6-month time period over the preceding 5 years. Surgery was performed on one of four types of lists: Manchester Royal Eye Hospital standard lists (MREH), Cataract Services list, Waiting List Initiative list (WLI), and Diagnostic and Treatment Centre list (DTC). Surgeons were identified by their specific codes and divided into grades.
Results
The total number of cataract operations undertaken on the standard MREH lists has declined significantly over the years (P<0.001 
2 test for trend). The number of cataract operations performed by both Specialist Registrars (SpRs) and Senior House Officers (SHOs) demonstrated a statistically significant decline over the years (P<0.001 for both cases, 2 test for trend), with the SHOs number dropping dramatically over the last 2 years. When comparing the number of operations performed by junior SpRs and senior SpRs, shift in the balance can be seen towards the senior surgeons. The proportion of operations performed by junior SpRs declined from 50% in 2000 to 28.2% in 2005.
Conclusion
Recent changes in cataract care provision have had a significant impact on training. Our results document for the first time that both higher and basic surgical trainees were affected. Future care of our patients could be comprised owing to lack of training.
Keywords:
'Action on Cataracts', cataract, training, DTC
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