Smt. Kanuri Santhamma Centre for Vitreo Retinal Diseases, LV Prasad Eye Institute, Banjara Hills, Hyderabad, Telangana, India.
Indian J Ophthalmol. 2020 Jan;68(1):78-82. doi: 10.4103/ijo.IJO_524_19.
To evaluate surgical outcomes, complications and learning curve of glued intraocular lens surgery by a vitreoretinal (VR) fellow in training.
Analysis of 50 eyes requiring glued intraocular lens (GIOL) surgery for various indications was done. Both the consultant VR surgeon (Group 1) and VR fellow in training (Group 2) operated 25 eyes each. The primary outcome measures were visual acuity at 3 months, and time taken for completion of surgery. Secondary outcome measures were refractive correction, intraocular pressure and intraoperative or postoperative complications.
The uncorrected visual acuity (UCVA) improved from log MAR 1.54±0.56 (Snellen 20/693) to 0.45±0.26 (Snellen 20/56) and from 1.64±0.53 (Snellen 20/873) to 0.56±0.45 (Snellen 20/72) in group 1 and 2, respectively. The best corrected visual acuity (BCVA) improved from log MAR 0.74±0.61 (Snellen 20/109) to 0.33±0.26 (Snellen 20/42) and from 1±0.68 (Snellen 20/200) to 0.40±0.50 (Snellen 20/50) in group 1 and 2, respectively (P > 0.05). The surgical time was significantly less in group 1 when compared to that of group 2 (64.26 vs 107.16 minutes) P value <0.05). The mean time taken for the initial 10 cases and later 15 cases in group 2 were 131.9 and 91.2 minutes, which was statistically significant. The complication rates in both groups were comparable. Transient hypotony (IOP < 11) was seen in 56% (14/25) of eyes in group 2 and 44% (11/25) in group 1 (P = 0.39).
The study results are encouraging for a VR fellow with good short-term visual outcomes and comparable surgical complications. The procedure gives promising results and the learning curve is overcome by a desire to learn and with increasing number of procedures done under supervision.
评估由玻璃体视网膜（VR）受训研究员进行胶合人工晶状体（GIOL）手术的手术结果、并发症和学习曲线。
对 50 只因各种适应证需要胶合人工晶状体（GIOL）手术的眼睛进行了分析。顾问 VR 外科医生（第 1 组）和 VR 受训研究员（第 2 组）各进行了 25 只眼睛的手术。主要的结局测量指标是术后 3 个月的视力和手术完成时间。次要结局测量指标包括屈光矫正、眼内压和术中或术后并发症。
未矫正视力（UCVA）从 logMAR 1.54±0.56（Snellen 20/693）提高到 0.45±0.26（Snellen 20/56），从 1.64±0.53（Snellen 20/873）提高到 0.56±0.45（Snellen 20/72），第 1 组和第 2 组分别为 0.74±0.61（Snellen 20/109）提高到 0.33±0.26（Snellen 20/42），从 1±0.68（Snellen 20/200）提高到 0.40±0.50（Snellen 20/50）。第 1 组手术时间明显短于第 2 组（64.26 分钟对 107.16 分钟）（P <0.05）。第 2 组前 10 例和后 15 例的平均手术时间分别为 131.9 分钟和 91.2 分钟，差异有统计学意义。两组的并发症发生率相似。第 2 组 56%（14/25）的眼出现短暂低眼压（IOP <11），第 1 组 44%（11/25）（P =0.39）。
对于一名具有良好短期视力结果和可比较手术并发症的 VR 研究员来说，该研究结果令人鼓舞。该手术操作结果有前景，学习曲线可以通过学习意愿和在监督下完成的手术数量的增加来克服。
