Prasad S
Royal Eye Infirmary, Dorset County Hospital, England.
J Cataract Refract Surg. 1998 Jan;24(1):73-7. doi: 10.1016/s0886-3350(98)80077-1.
To establish the incidence of complications during surgery performed by junior trainees learning phacoemulsification.
Eye infirmary in a United Kingdom district general hospital.
A retrospective review of case notes of the first 102 cases of phacoemulsification procedures performed by two senior house officers was done. Main outcome measures were change in surgical plan, position of implanted lens, posterior capsule tear, vitreous loss, zonule loss, and visual outcome at discharge. Follow-up was 6 weeks.
A posterior capsule tear occurred in 6 eyes (5.8%) and vitreous loss in 3 (2.9%). All eyes had a posterior chamber lens, 6 (5.8%) implanted in the sulcus and 96 (94.2%), in the capsular bag. Eleven eyes (10.8%) had a visual acuity of 6/18 or worse at discharge: of these, 10 had pre-existing pathology in keeping with the level of acuity. In the other eye, there was no apparent cause for the 6/18 acuity.
The study indicates that junior trainees can be taught phacoemulsification with acceptable complication rates and visual results. The results compare favorably with reports of senior surgeons converting to phacoemulsification, trainee surgeons learning extracapsular surgery, and recently reported phacoemulsification series.
确定初级学员学习超声乳化手术期间并发症的发生率。
英国一家地区综合医院的眼科门诊。
对两名高级住院医师进行的前102例超声乳化手术病例记录进行回顾性研究。主要观察指标包括手术计划的改变、植入晶状体的位置、后囊膜撕裂、玻璃体丢失、悬韧带丢失以及出院时的视力结果。随访时间为6周。
6只眼（5.8%）发生后囊膜撕裂，3只眼（2.9%）发生玻璃体丢失。所有眼睛均植入后房型人工晶状体，6只眼（5.8%）植入睫状沟，96只眼（94.2%）植入囊袋内。11只眼（10.8%）出院时视力为6/18或更差：其中10只眼存在与视力水平相符的原有病变。另一只眼视力为6/18，无明显原因。
该研究表明，初级学员可以学习超声乳化手术，并发症发生率和视力结果均可接受。该结果与资深外科医生改行做超声乳化手术、实习外科医生学习囊外手术的报告以及最近报道的超声乳化手术系列结果相比具有优势。
