Department of Ophthalmology, Medical University of Graz, Graz, Austria.
Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria.
PLoS One. 2022 Dec 27;17(12):e0279518. doi: 10.1371/journal.pone.0279518. eCollection 2022.
To assess the rate of pseudophakic cystoid macular edema (pCME) in uneventful cataract surgery in surgeons in training vs experienced surgeons and to analyze the rate of pCME according to surgeon's sex.
Medical reports post phacoemulsification between 2010 and 2018 at the Department of Ophthalmology, Medical University of Graz, Austria, were reviewed for pCME. A running lifetime number of preceding cataract surgeries was used to express hands-on experience. A cut-off number of 300 surgeries was defined to distinguish between surgeons in training and experienced surgeons. Outcome parameters were incidence of pCME, patient's sex and age, laterality of eye, coexistence of pseudoexfoliation syndrome (PEX), duration of surgery and surgeon's sex.
25.422 surgeries on 18.266 patients were included. The majority was performed by experienced surgeons (23.139, 91.0%) vs 2.283 (9.0%) by surgeons in training (25 surgeons, 9 (36%) female and 16 (64%) male). pCME occurred in 32 eyes (1.4%) following surgery by surgeons in training and in 152 eyes (0.7%) following surgery by experienced surgeons. Chance for pCME was 1.57 higher in training surgeries (95% CI 1.03-2.41, p = 0.034) and longer duration (OR = 1.04; 95% CI 1.02-1.07, p = 0.001). After excluding the first 100 surgeries for every surgeon in training similar results were observed. No difference in risk for pCME was found between female and male surgeons in both groups (training and experienced surgeons).
In conclusion, the rate for pCME after uneventful cataract surgery is significantly higher for surgeons in training but steadily decreasing and associated to surgical time. No difference in the risk for pCME was found between female and male surgeons.
评估在接受培训的外科医生和经验丰富的外科医生进行无并发症白内障手术后假性囊泡性黄斑水肿（pCME）的发生率，并根据外科医生的性别分析 pCME 的发生率。
回顾 2010 年至 2018 年期间在奥地利格拉茨医科大学眼科进行的超声乳化手术后的医学报告，以评估 pCME。使用白内障手术的累积数量来表示手术经验。将 300 例手术作为区分培训外科医生和经验丰富外科医生的截止值。研究的结果参数为 pCME 的发生率、患者的性别和年龄、眼的侧别、假性剥脱综合征（PEX）的共存、手术持续时间和外科医生的性别。
共有 18266 名患者的 25422 例手术纳入研究。大多数手术由经验丰富的外科医生（23139 例，91.0%）完成，而仅由培训外科医生（25 名，36%为女性，64%为男性）完成的手术为 2283 例（9.0%）。培训外科医生手术后的 32 只眼（1.4%）和经验丰富的外科医生手术后的 152 只眼（0.7%）发生了 pCME。培训手术发生 pCME 的几率是经验丰富手术的 1.57 倍（95%CI 1.03-2.41，p=0.034），且手术时间较长（OR=1.04；95%CI 1.02-1.07，p=0.001）。排除每位培训外科医生的前 100 例手术后，观察到类似的结果。在两组（培训和经验丰富的外科医生）中，女性和男性外科医生发生 pCME 的风险无差异。
总之，在无并发症白内障手术后，接受培训的外科医生发生 pCME 的比率明显较高，但随着手术时间的推移，该比率逐渐下降。在 pCME 的风险方面，女性和男性外科医生之间没有差异。
