Jeang Lauren J, Liechty Jacob J, Powell Asyvia, Schwartz Christopher, DiSclafani Mark, Drucker Mitchell D, McDowell William M
University of South Florida Department of Ophthalmology, Tampa, Florida.
University of South Florida School of Medicine, Tampa, Florida.
J Acad Ophthalmol (2017). 2022 Mar 10;14(1):e70-e73. doi: 10.1055/s-0042-1744270. eCollection 2022 Jan.
To determine if a structured surgical wet laboratory curriculum for ophthalmology residents reduced the rate of posterior capsule rupture (PCR) in phacoemulsification cataract surgery. James A. Haley Veterans' Hospital, Tampa, FL. Retrospective cohort study. The study assessed resident-performed phacoemulsification cataract cases from 2011 to 2017, after the creation of a wet laboratory course. Primary outcome measure was PCR. If present, timing of complication, dropped lens fragments, and the need for anterior vitrectomies were noted. Self-reported rates of PCR prior to institution of a wet laboratory course (2010-2011) were compared with cases done by residents who completed the course (2011-2017). A total of 3,445 cases were reviewed of which 2.44% (84 cases) noted PCR. Of these, 19% (16) had dropped lens fragments, and 60.7% (51) required anterior vitrectomy. Sixty-nine cases documented timing of PCR with the majority, 58%, occurring during phacoemulsification. When comparing rates of PCR in cases done prior to the presence of a wet laboratory course versus after, there was a significant reduction observed (5.20% before vs. 2.44% after). In the presence of a wet laboratory curriculum, the rate of PCR decreased dramatically. The average rate was lower than those reported at other training programs (2.6-9.9%). Most PCR occurred during phacoemulsification, suggesting need for further focused instruction in this step.
为了确定针对眼科住院医师的结构化手术湿实验室课程是否能降低白内障超声乳化手术中后囊破裂（PCR）的发生率。 詹姆斯·A·黑利退伍军人医院，佛罗里达州坦帕市。 回顾性队列研究。 该研究评估了2011年至2017年在开设湿实验室课程后住院医师进行的白内障超声乳化病例。主要结局指标是PCR。如果发生PCR，记录并发症发生时间、晶状体碎片掉落情况以及是否需要进行前部玻璃体切除术。将开设湿实验室课程之前（2010 - 2011年）自我报告的PCR发生率与完成该课程的住院医师所做病例（2011 - 2017年）进行比较。 共审查了3445例病例，其中2.44%（84例）出现PCR。其中，19%（16例）有晶状体碎片掉落，60.7%（51例）需要进行前部玻璃体切除术。69例记录了PCR发生时间，其中大多数（58%）发生在超声乳化过程中。比较开设湿实验室课程之前和之后病例的PCR发生率，发现有显著降低（之前为5.20%，之后为2.44%）。 在有湿实验室课程的情况下，PCR发生率显著下降。平均发生率低于其他培训项目报告的发生率（2.6 - 9.9%）。大多数PCR发生在超声乳化过程中，表明在这一步骤需要进一步有针对性的指导。
