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即刻序贯双侧白内障手术:欧洲眼科医生的基本原理、实施和理念。

Immediate sequential bilateral cataract surgery: The rationale, implementation, and beliefs of ophthalmic surgeons across Europe.

机构信息

Brighton & Sussex Medical School, Brighton, England.

Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Iran.

出版信息

J Cataract Refract Surg. 2019 Dec;45(12):1725-1731. doi: 10.1016/j.jcrs.2019.07.027.

DOI:10.1016/j.jcrs.2019.07.027
PMID:31856982
Abstract

PURPOSE

To assess the attitudes and beliefs held toward immediate sequential bilateral cataract surgery (ISBCS), including estimating the incidence of European Society of Cataract and Refractive Surgeons (ESCRS) members currently performing ISBCS, exploring the barriers of ISBCS implementation, and assessing the relevance of these findings to practice in the United Kingdom.

SETTING

European consultant members of the ESCRS.

DESIGN

Survey-based questionnaire.

METHODS

The survey was sent and collected electronically. An initial screening question directed the rest of the survey; participants were asked to rate the importance of several factors with regard to performing ISBCS. Free text options were also available. Descriptive analysis was performed.

RESULTS

Of the 2200 recipients, 303 (13.7%) responded, of which 247 were eligible for analysis. Of the 247 eligible respondents, 166 (67.2%) reported performing ISBCS, 71 (28.7%) said they did not perform ISBCS, and 10 (4.0%) said they had previously done so but have since stopped. Of those who were currently practicing ISBCS, the three most important factors to consider were all directly related to infection risk. Of those who did not perform ISBCS, the most important reasons for not performing the surgery were a risk for endophthalmitis (69.0%) and the medicolegal issues should ISBCS go wrong (57.8%). The most common reason for stopping ISBCS was that the respondent no longer believed in the benefit of ISBCS (n = 4).

CONCLUSIONS

The survey reflects ophthalmologists' concerns regarding infection and medicolegal risks; however, reports of bilateral endophthalmitis are extremely rare when the correct recommendations are followed. The findings from this survey could be used to inform service provision of ISBCS in the U.K., taking into consideration the voices of colleagues overseas.

摘要

目的

评估对立即序贯双侧白内障手术(ISBCS)的态度和信念,包括估计目前正在实施 ISBCS 的欧洲白内障和屈光外科医师学会(ESCRS)成员的发生率,探讨实施 ISBCS 的障碍,并评估这些发现与英国实践的相关性。

设置

ESCRS 的欧洲顾问成员。

设计

基于调查的问卷。

方法

通过电子方式发送和收集调查。一个初始筛选问题指导了其余的调查;参与者被要求对实施 ISBCS 的几个因素的重要性进行评分。也提供了自由文本选项。进行了描述性分析。

结果

在 2200 名收件人中,有 303 人(13.7%)做出了回应,其中 247 人符合分析条件。在 247 名符合条件的受访者中,有 166 人(67.2%)报告实施了 ISBCS,71 人(28.7%)表示他们没有实施 ISBCS,10 人(4.0%)表示他们之前实施过,但后来停止了。在目前正在实施 ISBCS 的人中,考虑的三个最重要因素都与感染风险直接相关。在没有实施 ISBCS 的人中,不进行手术的最重要原因是发生眼内炎的风险(69.0%)和如果 ISBCS 出现问题的医疗法律问题(57.8%)。停止 ISBCS 的最常见原因是受访者不再相信 ISBCS 的益处(n=4)。

结论

该调查反映了眼科医生对感染和医疗法律风险的担忧;然而,在遵循正确建议的情况下,双侧眼内炎的报告极为罕见。该调查的结果可用于告知英国 ISBCS 的服务提供,同时考虑到海外同行的意见。

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