Pick Zelda S, Leaming David V, Elder Mark J
Department of Ophthalmology, Christchurch Hospital, Christchurch, New Zealand.
Clin Exp Ophthalmol. 2008 Oct;36(7):604-19. doi: 10.1111/j.1442-9071.2008.01869.x.
To examine the current practice and changing trends for cataract and refractive surgery in New Zealand (NZ) between 1997 and 2007.
A self-administered confidential postal questionnaire was sent to all consultant ophthalmologists practising in NZ in 2007, eliciting surgical volumes and technique, anaesthetic, preferred equipment and patient management. Results were compared with previous NZ surveys and international surveys of surgeons in Northern America, Europe and the UK.
From the 113 ophthalmologists surveyed 88% responded, comprising 86 cataract surgeons and 20 refractive surgeons. Key findings for cataract surgeons were: 65% routinely used sub-Tenon's anaesthetic, 20% topical anaesthetic, 24% favoured intracameral antibiotics, 88% operated via clear corneal or anterior limbal incisions and 61% used temporal incisions. Acrylic foldable intraocular lenses (IOLs) were preferred, 27% of surgeons routinely used aspheric IOLs, 31% used presbyopia-correcting IOLs and 63% expressed high interest in toric IOLs. Of the refractive surgeons, 83% would perform bilateral LASIK at the same surgical event; phakic IOL was the treatment of choice for 30-year-old -12D myopes, and clear lens exchange for 45-year-old +5D hyperopes.
The majority of NZ cataract surgical practice remains comparable with results from international surveys. A notable exception, as in previous comparisons, is a lower use of topical anaesthetic in NZ with a higher use of sub-Tenon's anaesthetic instead. Refractive surgery practice in NZ is generally comparable with that of American Society of Cataract and Refractive Surgery members.
研究1997年至2007年间新西兰白内障和屈光手术的当前做法及变化趋势。
2007年向所有在新西兰执业的眼科顾问医生发送了一份自我填写的保密邮政调查问卷，询问手术量、技术、麻醉方式、首选设备和患者管理情况。将结果与新西兰以前的调查以及北美、欧洲和英国外科医生的国际调查结果进行比较。
在接受调查的113名眼科医生中，88%做出了回应，其中包括86名白内障外科医生和20名屈光外科医生。白内障外科医生的主要调查结果如下：65%的医生常规使用球周麻醉，20%使用表面麻醉，24%倾向于前房内使用抗生素，88%通过透明角膜或角膜缘切口进行手术，61%使用颞侧切口。首选丙烯酸可折叠人工晶状体（IOL），27%的外科医生常规使用非球面IOL，31%使用矫正老花眼的IOL，63%对散光IOL表现出浓厚兴趣。在屈光外科医生中，83%会在同一次手术中进行双侧准分子激光原位角膜磨镶术（LASIK）；有晶状体眼人工晶状体是30岁、近视度数为-12D患者的首选治疗方法，而透明晶状体置换术则是45岁、远视度数为+5D患者的首选治疗方法。
新西兰大多数白内障手术做法与国际调查结果仍具有可比性。与以前的比较一样，一个显著的例外是新西兰表面麻醉的使用较少，而球周麻醉的使用较多。新西兰的屈光手术做法总体上与美国白内障与屈光手术学会成员的做法相当。
