Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute, University of Sydney, Hawkesbury Road, Westmead, NSW 2145, Australia.
Clin Exp Ophthalmol. 2012 Aug;40(6):597-603. doi: 10.1111/j.1442-9071.2012.02759.x. Epub 2012 Mar 21.
It is unclear whether differences exist in surgical complication rates and long-term visual acuity outcomes between patients whose phacoemulsification cataract surgery was performed by ophthalmological trainees and those performed by consultants.
Prospective clinical cohort study.
1851 participants of the Cataract Surgery and Age-related Macular Degeneration study, aged ≥64 years, had cataract surgery performed at Westmead Hospital, Sydney.
Surgical complication rates and visual acuity at 24-month postoperative visits were compared between patients who were operated on by trainees and those operated on by consultants.
Surgical outcomes included operative complications recorded in surgical audit forms and 24-month postoperative visual acuity.
Of 1851 patients, 1274 (68.8%) were reviewed 24 months after surgery. Of these, 976 had data on the type of surgeon who performed the operation. After excluding 152 challenging cases and three cases operated on by first-year trainees at the beginning of their training, 821 patients were included in this study, of those, 498 were operated on by trainees and 323 by consultants. Habitual visual acuity ≥6/12 was achieved in 77.3% (n = 385/498) and 74.3% (n = 240/323), respectively, of the two groups of patients 24 months postoperatively. Of 514 patients who had surgical audit data, the major complication rate was numerically greater, but not significantly different for the 330 trainee-operated (6.1%) patients, compared with the 184 consultant-operated patients (2.7%, P = 0.091).
We found relatively comparable complication rates and visual outcomes after 2 years between patients operated on by ophthalmological trainees and those by consultants, in a cataract surgical cohort at Westmead Hospital.
行白内障超声乳化术的眼科受训医师和主治医生在手术并发症发生率和长期视力预后方面是否存在差异尚不明确。
前瞻性临床队列研究。
西悉尼大学韦斯特米德医院的 1851 名年龄≥64 岁的白内障手术患者参加了白内障手术与年龄相关性黄斑变性研究。
比较受训医生和主治医生手术患者的手术并发症发生率和术后 24 个月视力。
手术结局包括手术记录中的手术并发症和术后 24 个月视力。
1851 例患者中，1274 例（68.8%）术后 24 个月进行了随访。其中，976 例患者的手术医生类型数据完整。排除 152 例复杂病例和 3 例培训初期第一年受训医生手术病例后，本研究共纳入 821 例患者，其中 498 例由受训医生手术，323 例由主治医生手术。术后 24 个月，两组患者分别有 77.3%（n=385/498）和 74.3%（n=240/323）达到习惯性视力≥6/12。在有手术记录的 514 例患者中，受训医生手术患者（6.1%，330 例）的主要并发症发生率虽高于主治医生手术患者（2.7%，184 例），但差异无统计学意义（P=0.091）。
在西悉尼大学韦斯特米德医院的白内障手术队列中，我们发现受训医生和主治医生手术患者的术后 2 年并发症发生率和视力结局相对相似。
