Tarbet K J, Mamalis N, Theurer J, Jones B D, Olson R J
Moran Eye Center, University of Utah, Salt Lake City, USA.
J Cataract Refract Surg. 1995 Nov;21(6):661-5. doi: 10.1016/s0886-3350(13)80562-7.
The use of phacoemulsification by ophthalmic surgeons has increased markedly over the past five years. Previous studies have reported relatively high rates of vitreous loss by residents learning phacoemulsification. We retrospectively analyzed the complications and results in 300 cases of phacoemulsification with intraocular lens implantation performed by residents. The first 40 cases done by four residents in their second year of training were compared with approximately the last 40 cases done by each resident at the end of the third year. The overall rate of surgical complications was 6.3%, and the total rate of vitreous loss was 3.3%. The rate of surgical complications during the initial surgeries in the second year of residency was 9.3%; it was 3.3% by the end of the third year. The rate of vitreous loss was 5.3% in the second year and 1.3% during the third year. Postoperatively, 90.6% of all eyes had a final best corrected visual acuity of 20/40 or better (95% excluding patients with pre-existing ocular disease). With proper training and supervision, the rate of surgical complications for residents learning phacoemulsification is acceptably low when compared with the rate of extracapsular cataract extraction.
在过去五年中，眼科医生进行超声乳化手术的比例显著增加。先前的研究报告称，学习超声乳化手术的住院医生玻璃体丢失率相对较高。我们回顾性分析了住院医生进行的300例白内障超声乳化吸除联合人工晶状体植入术的并发症及手术结果。将四名住院医生在培训第二年完成的前40例手术与每名住院医生在第三年末完成的约最后40例手术进行比较。手术并发症总发生率为6.3%，玻璃体丢失总发生率为3.3%。住院医生培训第二年初期手术的并发症发生率为9.3%；到第三年末为3.3%。玻璃体丢失率在第二年为5.3%，第三年为1.3%。术后，所有术眼中有90.6%的最终最佳矫正视力达到20/40或更好（95%排除术前已有眼部疾病的患者）。通过适当的培训和监督，与囊外白内障摘除术的发生率相比，学习超声乳化手术的住院医生的手术并发症发生率低至可接受水平。
