Bhagat Neelakshi, Nissirios Nicholas, Potdevin Lindsay, Chung Jacob, Lama Paul, Zarbin Marco A, Fechtner Robert, Guo Suquin, Chu David, Langer Paul
The Institute of Ophthalmology and Visual Science, New Jersey Medical School, Doctors Office Center, Suite 6168, 90 Bergen Street, Newark, NJ 07103, USA.
Br J Ophthalmol. 2007 Oct;91(10):1315-7. doi: 10.1136/bjo.2006.111971. Epub 2007 Apr 12.
To describe the complications related to cataract surgery performed by phacoemulsification technique by third-year ophthalmology residents at New Jersey Medical School, who are trained to perform phacoemulsification without any prior experience with extracapsular extraction.
Retrospective, observational case series.
A retrospective chart review of 755 patients who underwent cataract surgery by third-year residents between July 2000 and June 2005 at the Institute of Ophthalmology and Visual Science was performed. Details of intraoperative complications (posterior capsular rupture, vitreous loss, subluxation of lens fragments into the vitreous, extracapsular cases converted to phacoemulsification, retinal detachment, vitreous haemorrhage and haemorrhagic choroidals) of the cases done by phacoemulsification technique were recorded. Results were analysed and compared with complication rates reported from other residency programmes and from experienced ophthalmologists.
Of 755 cataract surgeries, 719 were performed using phacoemulsification technique. Posterior capsule disruption occurred in 48 (6.7%), vitreous loss in 39 (5.4%) and dislocated lenticular fragments in 7 (1.0%) of 719 cases that underwent phacoemulsification technique. Subsequent pars plana lensectomy was required in 5 (0.7%) cases; 1 case (0.1%) experienced retinal detachment and haemorrhagic choroidal detachment.
The residents can perform phacoemulsification well with a very low complication rate, without prior training with extracapsular cataract extraction technique.
描述新泽西医学院三年级眼科住院医师采用超声乳化技术进行白内障手术的相关并发症,这些住院医师在未接受过任何囊外摘除术经验培训的情况下接受超声乳化技术培训。
回顾性观察病例系列。
对2000年7月至2005年6月期间在眼科与视觉科学研究所由三年级住院医师进行白内障手术的755例患者进行回顾性病历审查。记录采用超声乳化技术的病例的术中并发症(后囊破裂、玻璃体丢失、晶状体碎片半脱位至玻璃体、囊外病例转为超声乳化、视网膜脱离、玻璃体出血和出血性脉络膜脱离)细节。分析结果并与其他住院医师培训项目和经验丰富的眼科医生报告的并发症发生率进行比较。
在755例白内障手术中,719例采用超声乳化技术。在719例接受超声乳化技术的病例中,48例(6.7%)发生后囊破裂,39例(5.4%)发生玻璃体丢失,7例(1.0%)发生晶状体碎片脱位。5例(0.7%)需要随后进行经平坦部晶状体切除术;1例(0.1%)发生视网膜脱离和出血性脉络膜脱离。
住院医师在未接受囊外白内障摘除技术预先培训的情况下,能够以非常低的并发症发生率很好地进行超声乳化手术。