Albanis C V, Dwyer M A, Ernest J T
University of Chicago, Visual Sciences Center, IL 60637, USA.
Ophthalmic Surg Lasers. 1998 Aug;29(8):643-8.
As the number of older Americans increases, more patients will need cataract extraction surgery. Outcome studies will be necessary to assess and improve the quality of care. This study documents the outcomes of extracapsular cataract extraction (ECCE) performed at Oak Forest County Hospital (OFH) and phacoemulsification (PE) performed at the University of Chicago Hospitals (UCH) by residents who were training at the University of Chicago.
Residents train using ECCE during their second year at OFH, and learn PE at the UCH during their third year. The authors performed a chart review of all patients who had undergone ECCE at OFH (N = 52) and all patients who had undergone PE at the UCH (N = 343) from 1995 through 1997. Complete preoperative, intraoperative, and postoperative clinical data were recorded on the American Society of Cataract and Refractive Surgery database.
There were no intraoperative complications at OFH, and 23 of 52 (44%) of the eyes had a final best-corrected visual acuity (BCVA) of 20/40 or better. At the UCH, vitreous loss occurred in 16 of 343 (5%) of the PE patients. A final BCVA of 20/40 or better was achieved in 300 of 343 (87%) of the PE eyes.
The visual outcomes of patients who undergo ECCE at a county hospital are poor, but the surgical complications are minimal. The visual outcomes of patients who undergo PE at a university hospital are good, but the complication rates are slightly higher.
随着美国老年人口数量的增加,越来越多的患者将需要进行白内障摘除手术。有必要开展结果研究以评估和改善护理质量。本研究记录了在橡树森林县医院(OFH)接受囊外白内障摘除术(ECCE)以及在芝加哥大学医院(UCH)接受超声乳化白内障吸除术(PE)的患者的手术结果,这些患者均为在芝加哥大学接受培训的住院医师所治疗。
住院医师在OFH的第二年使用ECCE进行培训,并在UCH的第三年学习PE。作者对1995年至1997年期间在OFH接受ECCE的所有患者(N = 52)以及在UCH接受PE的所有患者(N = 343)进行了病历回顾。完整的术前、术中和术后临床数据记录在美国白内障与屈光手术学会数据库中。
在OFH没有术中并发症发生,52只眼中有23只(44%)最终最佳矫正视力(BCVA)达到20/40或更好。在UCH,343例PE患者中有16例(5%)发生玻璃体脱出。343只PE眼中有300只(87%)最终BCVA达到20/40或更好。
在县医院接受ECCE的患者视觉效果较差,但手术并发症极少。在大学医院接受PE的患者视觉效果良好,但并发症发生率略高。