{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:03:01Z","timestamp":1790053381710,"version":"4.0.1"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Ophthalmol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>This study aimed to assess one-year outcomes of phacoemulsification cataract surgery at King Khaled Eye Specialist Hospital (KKESH), a tertiary referral teaching hospital in Saudi Arabia. Evaluated outcomes included intraoperative complications, postoperative visual outcomes, and the association of surgeon experience and surgical complexity with posterior capsule rupture (PCR) and visual outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review included 3,377 eyes that underwent phacoemulsification cataract surgery between January 1 and December 31, 2019. Data were extracted from TrakCare, the hospital\u2019s electronic medical record system. Variables included demographics, pre- and postoperative visual acuity, intraoperative complications, combined surgical procedures, and surgeon experience. Statistical analyses were performed using Stata version 16.1. Comparisons between surgeon groups were performed using analysis of variance and chi-square tests. Multivariable logistic regression was used to identify factors associated with PCR, and multivariable linear regression was performed to evaluate predictors of postoperative visual acuity. Statistical significance was defined as P &amp;lt; 0.05.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 3,377 phacoemulsification cataract surgeries were included. The mean patient age was 62.7 \u00b1 13.1 years, 50.8% were male, and diabetes was present in 14.0% of patients. The overall posterior capsule rupture (PCR) rate was 2.8%. Although attending surgeons managed patients with poorer preoperative visual acuity and performed a greater proportion of combined procedures, surgeon level was not independently associated with PCR after adjustment for patient and surgical factors. Combined surgery was independently associated with a higher likelihood of PCR (adjusted OR 2.44, 95% CI 1.41\u20134.25; P = 0.002). Postoperative visual acuity improved significantly overall, while poorer postoperative visual acuity was independently associated with combined surgery, diabetes, and worse preoperative visual acuity, but not with PCR after multivariable adjustment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Phacoemulsification cataract surgery at a tertiary referral eye center achieved low complication rates and favorable visual outcomes, consistent with international benchmarks. After adjustment for baseline characteristics, surgical complexity rather than surgeon experience was independently associated with PCR and postoperative visual outcomes. These findings support structured case allocation in teaching hospitals and provide valuable benchmarks for surgical training and quality improvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fopht.2026.1882657","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:21:00Z","timestamp":1790050860000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of surgical complexity and surgeon experience on phacoemulsification outcomes: a one-year retrospective study from a Saudi tertiary eye hospital"],"prefix":"10.3389","volume":"6","author":[{"given":"Rafah","family":"Fairaq","sequence":"first","affiliation":[{"name":"Anterior Segment Division, King Khaled Eye Specialist Hospital","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Mohammed","family":"Almuwarraee","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, Prince Sultan Military Medical City","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Ayedh","family":"Almatrafi","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, Prince Sultan Military Medical City","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wejdan Saeed","family":"Alghamdi","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, King Fahad Hospital","place":["Al Baha, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lojain Mohammed","family":"Maawadh","sequence":"additional","affiliation":[{"name":"College of Medicine, Imam Abdulrahman Bin Faisal University","place":["Dammam, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajiv","family":"Khandekar","sequence":"additional","affiliation":[{"name":"Research Department, King Khaled Eye Specialist Hospital","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Almutlak","sequence":"additional","affiliation":[{"name":"Anterior Segment Division, King Khaled Eye Specialist Hospital","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anwar","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Research Department, King Khaled Eye Specialist Hospital","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Ali","family":"Ahad","sequence":"additional","affiliation":[{"name":"Anterior Segment Division, King Khaled Eye Specialist Hospital","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halah","family":"Bin Helayel","sequence":"additional","affiliation":[{"name":"Anterior Segment Division, King Khaled Eye Specialist Hospital","place":["Riyadh, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"B1","article-title":"Cost-effectiveness analysis of cataract surgery: a global and regional analysis","volume":"82","author":"Baltussen","year":"2004","journal-title":"Bull World Health Organ"},{"key":"B2","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1097\/ICU.0b013e3283414284","article-title":"The impact of cataract surgery on quality of life","volume":"22","author":"Lamoureux","year":"2011","journal-title":"Curr Opin Ophthalmol"},{"key":"B3","volume-title":"World Report on 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