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对学员进行的囊外白内障摘除术并发症的评估。

Evaluation of complications of extracapsular cataract extraction performed by trainees.

作者信息

Ezegwui Ir, Aghaji Ae, Okpala Ne, Onwasigwe En

机构信息

Department of Ophthalmology, University of Nigeria Teaching Hospital, Enugu, Nigeria.

Department of Ophthalmology, Guinness Eye Centre, Onitsha, Nigeria.

出版信息

Ann Med Health Sci Res. 2014 Jan;4(1):115-7. doi: 10.4103/2141-9248.126616.

DOI:10.4103/2141-9248.126616
PMID:24669342
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3952281/
Abstract

BACKGROUND

Cataract extraction is the most common intraocular surgery taught to residents.

AIM

This study aims to review the complications of trainee-performed extracapsular cataract extraction (ECCE) so as to identify the steps in which the trainee can benefit from closer supervision and practice.

SUBJECTS AND METHODS

This was a descriptive retrospective study of complications in the initial 150 ECCE with intraocular lens implant performed by two Ophthalmologists, from the University of Nigeria Teaching Hospital, Enugu, who visited a high volume training center. Both the intraoperative and early post-operative complications were studied. Data entry and analysis were performed descriptively using the Statiscal Package for the Social Sciences, SPSS version 15.0 (Chicago, IL, USA).

RESULTS

The age range of the patients was 40-95 years. The intraoperative complications included capsular flaps 12/161 (7.5%), posterior capsule rent, 10/161 (6.2%) and vitreous loss, 8/161 (5.0%). Corneal complications (striate keratopathy, superior corneal edema, generalized corneal edema and corneal folds) ranked highest in post-operative complications accounting for 34% (56/164).

CONCLUSIONS

Performance of adequate and proper anterior capsulotomy, minimal handling of the cornea and avoidance of posterior capsular rent are some of the challenges of the trainee in mastering ECCE. Stepwise supervised training can help a trainee master these steps while keeping the complications at acceptably low levels.

摘要

背景

白内障摘除术是教授给住院医师的最常见的眼内手术。

目的

本研究旨在回顾受训者进行的囊外白内障摘除术(ECCE)的并发症,以确定受训者可从更密切的监督和实践中受益的步骤。

对象与方法

这是一项描述性回顾性研究,研究对象为尼日利亚大学教学医院埃努古分校的两名眼科医生在一家高容量培训中心进行的最初150例人工晶状体植入的ECCE手术的并发症。对术中及术后早期并发症均进行了研究。使用社会科学统计软件包(SPSS)15.0版(美国伊利诺伊州芝加哥)进行数据录入和描述性分析。

结果

患者年龄范围为40 - 95岁。术中并发症包括囊瓣问题12/161(7.5%)、后囊膜破裂10/161(6.2%)和玻璃体丢失8/161(5.0%)。角膜并发症(条纹状角膜病变、角膜上皮水肿、全身性角膜水肿和角膜皱褶)在术后并发症中占比最高,为34%(56/164)。

结论

进行充分且恰当的前囊切开、尽量减少对角膜的操作以及避免后囊膜破裂是受训者掌握ECCE的一些挑战。逐步的监督培训可帮助受训者掌握这些步骤,同时将并发症保持在可接受的低水平。

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Evaluation of complications of extracapsular cataract extraction performed by trainees.对学员进行的囊外白内障摘除术并发症的评估。
Ann Med Health Sci Res. 2014 Jan;4(1):115-7. doi: 10.4103/2141-9248.126616.
2
Long-term complications of extracapsular cataract extraction with posterior chamber intraocular lens implantation, in Nigeria.尼日利亚后房型人工晶状体植入式囊外白内障摘除术的长期并发症
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Visual outcomes after vitreous loss during cataract surgery performed by residents.住院医师进行白内障手术时发生玻璃体脱出后的视力预后
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本文引用的文献

1
Ophthalmic surgical training following modernising medical careers: regional variation in experience across the UK.眼科手术培训与现代医学职业发展:英国各地经验的地区差异。
BMJ Open. 2013 May 6;3(5):e002578. doi: 10.1136/bmjopen-2013-002578.
2
Complication rates of phacoemulsification and manual small-incision cataract surgery at Aravind Eye Hospital.艾利文眼科医院的超声乳化白内障吸除术与手法小切口白内障手术的并发症发生率。
J Cataract Refract Surg. 2012 Aug;38(8):1360-9. doi: 10.1016/j.jcrs.2012.04.025.
3
Manual small incision cataract surgery (MSICS) with posterior chamber intraocular lens versus extracapsular cataract extraction (ECCE) with posterior chamber intraocular lens for age-related cataract.手动小切口白内障手术(MSICS)联合后房型人工晶状体与囊外白内障摘除术(ECCE)联合后房型人工晶状体治疗年龄相关性白内障。
Cochrane Database Syst Rev. 2012 Apr 18(4):CD008811. doi: 10.1002/14651858.CD008811.pub2.
4
Cataract surgery in developing countries.发展中国家的白内障手术。
Curr Opin Ophthalmol. 2011 Jan;22(1):10-4. doi: 10.1097/ICU.0b013e3283414f50.
5
CUSUM: a dynamic tool for monitoring competency in cataract surgery performance.CUSUM:一种用于监测白内障手术能力的动态工具。
Br J Ophthalmol. 2010 Apr;94(4):445-9. doi: 10.1136/bjo.2009.163063. Epub 2009 Nov 30.
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Changing patterns in global blindness: 1988-2008.全球失明状况的变化趋势:1988 - 2008年
Community Eye Health. 2008 Sep;21(67):37-9.
7
Recognising 'high-risk' eyes before cataract surgery.白内障手术前识别“高危”眼睛。
Community Eye Health. 2008 Mar;21(65):12-4.
8
Cataract complications.白内障并发症。
Community Eye Health. 2008 Mar;21(65):1-3.
9
Cataract surgery for the developing world.为发展中世界开展的白内障手术。
Curr Opin Ophthalmol. 2008 Jan;19(1):55-9. doi: 10.1097/ICU.0b013e3282f154bd.
10
Sutureless cataract extraction: complications, management and learning curves.无缝线白内障摘除术:并发症、处理及学习曲线
Community Eye Health. 2003;16(48):58-60.