Thomas R, Naveen S, Jacob A, Braganza A
Schell Eye Hospital, Christian Medical College, Vellore, India.
Indian J Ophthalmol. 1997 Dec;45(4):215-9.
The increasing popularity of phacoemulsification in our country raises important training issues. We prospectively analyzed the incidence of complications and visual outcomes in the initial 70 phacoemulsifications (70 patients) performed by the first two residents learning phacoemulsification in our training programme. Both were experienced in standard (manual) extracapsular cataract extraction. Postoperative follow up of 6 weeks or longer was available in 59 eyes. The 11 patients (11 eyes) lost to follow up did not have any intra-operative complications. The overall incidence of vitreous loss was 10%, similar to the frequency of this complication (determined retrospectively) in the first 70 standard extracapsular cataract extractions performed by the same residents. Intraocular lenses (IOL) were successfully implanted in 62 eyes, as planned. One IOL dislocated into the vitreous was successfully repositioned. Other complications encountered included superior corneal edema (3 eyes), iris damage inferiorly (7 eyes) and clinical cystoid macular edema (5 eyes). A best corrected visual acuity of 6/12 or better was obtained in 56 (94.8%) of the 59 eyes available for the six week follow up. In the eyes with vitreous loss, 6 out of 7 had visual acuity better than 6/12. No nuclei were lost into the vitreous. The rate of surgical complications for residents learning phacoemulsification in a supervised manner can be acceptably low.
超声乳化白内障吸除术在我国日益普及，这引发了一些重要的培训问题。我们前瞻性地分析了在我们培训项目中最初由两名学习超声乳化白内障吸除术的住院医师进行的70例超声乳化白内障吸除术（70例患者）的并发症发生率和视力结果。这两名住院医师均有标准（手动）囊外白内障摘除术的经验。59只眼获得了6周或更长时间的术后随访。失访的11例患者（11只眼）术中无任何并发症。玻璃体丢失的总体发生率为10%，与这两名住院医师最初进行的70例标准囊外白内障摘除术（回顾性确定）中该并发症的发生率相似。按照计划，62只眼成功植入了人工晶状体（IOL）。一枚脱入玻璃体的IOL成功复位。其他遇到的并发症包括角膜上皮水肿（3只眼）、下方虹膜损伤（7只眼）和临床黄斑囊样水肿（5只眼）。在可进行6周随访的59只眼中，56只（94.8%）的最佳矫正视力达到6/12或更好。在发生玻璃体丢失的眼中，7只中有6只视力优于6/12。没有核掉入玻璃体。在有监督的情况下，学习超声乳化白内障吸除术的住院医师的手术并发症发生率可以低到可以接受的程度。
