To report the related factors of posterior capsule rupture and the difference of postoperative visual prognosis after phacoemulsification by analyzing clinical features of the surgery performed by ten novice ophthalmologists.

We retrospectively evaluated electronic medical records of 326 patients (412 phacoemulsification cases) who underwent surgery by novice ophthalmologists certified by the Board of Ophthalmology after a resident training program.

The number of cataract surgeries performed by each surgeon within the ophthalmology fellowship period (6 months - 2 years) ranged from 16 to 75 eyes, and perioperative posterior capsule ruptures occurred in 64 of 412 eyes (15.5%). Factors such as age, sex, laterality, axial length and clinical courses were not related to the rate of posterior capsule rupture. Nucleosclerosis was significantly related to the posterior capsule rupture rate and was especially higher in the group with a grade higher than five compared to that in the groups with a grade less than 5 based on the Lens Opacities Classification System III ( p = 0.033). Factors of surgeon's subspecialty, nucleofractis method, and period between residency and the fellowship were not related to the posterior capsule rupture rate, except when considering anesthetic methods. The posterior capsule rupture rate was less frequent in the retrobulbar surgery group than the topical surgery group ( p = 0.046). Postoperative visual outcomes were significantly different at postoperative day one and one month ( p = 0.023, 0.022, respectively) but not at postoperative two months ( p = 0.059).

Phacoemulsifications performed by novice ophthalmologists showed a statistically significant difference in posterior capsule rupture rate between nucleosclerosis and anesthesia groups. Postoperative visual outcome differed at postoperative day one and one month but not after two months postoperatively.