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在加拿大学术中心,比较眼科住院医师培训生和主治医生进行白内障手术的术中并发症发生率。

Intraoperative complication rates in cataract surgery performed by ophthalmology resident trainees compared to staff surgeons in a Canadian academic center.

机构信息

From the Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.

From the Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.

出版信息

J Cataract Refract Surg. 2018 Nov;44(11):1344-1349. doi: 10.1016/j.jcrs.2018.07.028. Epub 2018 Sep 7.

Abstract

PURPOSE

To compare the intraoperative complication rates in cataract surgery performed by resident trainees and staff ophthalmologists.

SETTING

Kensington Eye Institute, University of Toronto, Toronto, Canada.

DESIGN

Prospective case series.

METHODS

This study included 8738 consecutive cases of primary phacoemulsification cataract surgery performed by staff surgeons and resident trainees from January to December 2016. There were no exclusion criteria. Data collected included the level of resident training, case complexity, degree of resident involvement, and intraoperative complications. Primary outcome measures included intraoperative complication rates and level of complexity of cataract surgeries performed by resident trainees and staff surgeons.

RESULTS

Resident trainees were involved in 44% of surgeries. Of those, 82% were completed in their entirety by a resident and 18% were performed by both the staff surgeon and resident. Staff surgeons performed 56% of all surgeries without resident involvement. Sixty-seven percent of surgeries were simple and 33% were complex, with small pupil or intraoperative floppy-iris syndrome being the most common reason for complex cases. For simple cases, there was no difference in the overall complication rates (1.7% and 2.0%; P = .52), posterior capsule rupture rates (0.9% and 0.8%; P = .76), or vitreous loss rates (0.4% and 0.2%; P = .08) between staff and residents, respectively.

CONCLUSION

There were no differences in complication rates between the two groups.

摘要

目的

比较住院医师培训生与主治眼科医生在白内障手术中的术中并发症发生率。

地点

加拿大多伦多大学肯辛顿眼科研究所。

设计

前瞻性病例系列。

方法

这项研究纳入了 2016 年 1 月至 12 月期间由主治外科医生和住院医师培训生进行的 8738 例原发性超声乳化白内障手术的连续病例。没有排除标准。收集的数据包括住院医师培训水平、病例复杂性、住院医师参与程度以及术中并发症。主要观察指标包括住院医师培训生和主治外科医生进行的白内障手术的术中并发症发生率和手术复杂性程度。

结果

住院医师培训生参与了 44%的手术。其中,82%的手术完全由住院医师完成,18%的手术由主治外科医生和住院医师共同完成。主治外科医生在没有住院医师参与的情况下完成了 56%的手术。67%的手术为简单病例,33%为复杂病例,小瞳孔或术中虹膜松软综合征是复杂病例最常见的原因。对于简单病例,两组在总并发症发生率(分别为 1.7%和 2.0%;P=0.52)、后囊破裂发生率(分别为 0.9%和 0.8%;P=0.76)或玻璃体丢失发生率(分别为 0.4%和 0.2%;P=0.08)方面均无差异。

结论

两组的并发症发生率无差异。

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