Incidence of intraoperative complications in cataract surgery performed by left-handed residents

PURPOSE: To compare the incidence of intraoperative complications during cataract surgery performed by left-handed and right-handed residents and to find predictor variables for complications in resident-performed surgery. SETTING: Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA. METHODS: This retrospective chart review comprised cataract extractions performed by postgraduate fourth-year residents from July 1, 2001, to June 30, 2006. The incidence of posterior capsule tear and vitreous loss were the main outcomes. Univariate and multivariate logistic analyses incorporated the variables of patient age and sex; laterality of surgical eye; presence of diabetes mellitus, glaucoma, or age-related macular degeneration; history of vitrectomy; axial length; pseudoexfoliation; small pupils; white cataract; posterior polar cataract; handedness of resident; and academic quarter during which surgery occurred. RESULTS: Left-handed residents performed 170 (9.8%) of the 1730 surgeries. The incidence of posterior capsule tear and vitreous loss was significantly lower in surgeries performed by left-handed residents than in those performed by right-handed residents (P = .03 and P<.001, respectively). Multivariate logistic analysis showed that resident right-handedness and older patient age were predictive of an increased incidence of posterior capsule tear and vitreous loss. A small pupil was predictive of an increased incidence of vitreous loss. CONCLUSIONS: The incidence of posterior capsule tear and vitreous loss was significantly lower in cataract surgeries performed by left-handed residents. Handedness and patient age were significant predictor variables for these complications. J Cataract Refract Surg 2009; 35:1019-1025 (C) 2009 ASCRS and ESCRS