Bellan L, Dunn E, Black C
Department of Ophthalmology, Faculty of Medicine, University of Manitoba, Winnipeg.
Can J Ophthalmol. 1997 Aug;32(5):315-23.
To examine Canadian ophthalmologists' reported practices related to cataract surgery.
Mailed questionnaire survey.
Canada.
Random sample of 698 ophthalmologists from the mailing list of the Canadian Ophthalmological Society. Of the 528 eligible ophthalmologists 353 completed the questionnaire (response rate 67%). A total of 276 respondents were classified as cataract surgeons (performed at least one cataract operation in the preceding year [1992]) and were included in the study.
Reported use of preoperative ophthalmic tests, surgical technique, cataract anesthesia (including type of block and who administers it) and postoperative care.
Most of the preoperative tests examined either were so routine as to be done in almost all cases or were rarely done at all. A total of 52% of the respondents were identified as predominantly extracapsular cataract extraction surgeons (ECCE), 46% as predominantly phacoemulsification surgeons and 2% as predominantly intracapsular cataract extraction surgeons. Overall, 57% of the respondents reported high use of retrobulbar anesthesia, 18% reported high use of peribulbar anesthesia, and 0.7% reported high use of general anesthesia. The mean number of postoperative visits in the first 4 months after surgery was 4.25. The mean rate of Nd:YAG laser capsulotomy in the first year after cataract surgery was 17.9%; 91% of the respondents reported a rate less than 40%.
There seems to be limited use of nonessential preoperative ocular testing by Canadian cataract surgeons. Although ECCE remains the most common type of surgery performed, there appears to be a substantial number of surgeons trying phacoemulsification, and this will likely become the predominant technique in the near future. The self-reported practices of Canadian surgeons with relation to preoperative testing and postoperative follow-up appear to be consistent with the Clinical Practice Guideline for cataract surgery set by the US Agency for Health Care Policy and Research. However, variations in the number of postoperative visits and Nd:YAG capsulotomy rates merit further investigation.
调查加拿大眼科医生报告的与白内障手术相关的操作。
邮寄问卷调查。
加拿大。
从加拿大眼科学会邮寄名单中随机抽取698名眼科医生。在528名符合条件的眼科医生中，353名完成了问卷（回复率67%）。共有276名受访者被归类为白内障外科医生（在之前一年[1992年]至少进行了一次白内障手术）并纳入研究。
报告的术前眼科检查的使用情况、手术技术、白内障麻醉（包括阻滞类型及实施者）和术后护理。
所检查的大多数术前检查要么非常常规以至于几乎在所有病例中都会进行，要么很少进行。共有52%的受访者被确定为主要进行囊外白内障摘除术（ECCE）的外科医生，46%为主要进行超声乳化白内障吸除术的外科医生，2%为主要进行囊内白内障摘除术的外科医生。总体而言，57%的受访者报告大量使用球后麻醉，18%报告大量使用球周麻醉，0.7%报告大量使用全身麻醉。术后前4个月的平均复诊次数为4.25次。白内障手术后第一年钕:钇铝石榴石激光晶状体囊切开术的平均发生率为17.9%；91%的受访者报告发生率低于40%。
加拿大白内障外科医生对非必要的术前眼部检查的使用似乎有限。尽管ECCE仍然是最常进行的手术类型，但似乎有大量外科医生在尝试超声乳化白内障吸除术，并且这在不久的将来可能会成为主要技术。加拿大外科医生在术前检查和术后随访方面自我报告的操作似乎与美国医疗保健政策和研究机构制定的白内障手术临床实践指南一致。然而，术后复诊次数和钕:钇铝石榴石晶状体囊切开术发生率的差异值得进一步研究。
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