Ezegwui Ir, Aghaji Ae, Okpala Ne, Onwasigwe En
Department of Ophthalmology, University of Nigeria Teaching Hospital, Enugu, Nigeria.
Department of Ophthalmology, Guinness Eye Centre, Onitsha, Nigeria.
Ann Med Health Sci Res. 2014 Jan;4(1):115-7. doi: 10.4103/2141-9248.126616.
Cataract extraction is the most common intraocular surgery taught to residents.
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.
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).
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).
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.
白内障摘除术是教授给住院医师的最常见的眼内手术。
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。
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。
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)。
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。