低年资住院医师行手法小切口白内障手术的术后视力和玻璃体脱出发生率(英文)

Visual outcomes and incidence of vitreous loss among third-year ophthalmology residents performing manual small incision cataract surgery

目的:了解由第3a眼科住院医师所行的手法小切口白内障手术的患者术后视力和玻璃体脱出的发生率。方法:回顾分析2005-07/2007-06在Prapokklao医院眼科接受第3a住院医师行手法小切口白内障手术的连续799位患者的病历资料。对住院医师手术眼和本院医生手术眼的术后最佳矫正视力进行了比较。对于玻璃体脱出并发症,采用分析性病历对照研究方法对研究组(玻璃体脱出患者)和对照组(无玻璃体脱出患者)进行了对比。结果:术后1mo,住院医师组视力>6/18的患者为91%,本院医生组为92.5%,两者无统计学差异(P=0.526)。住院医师组中玻璃体脱出发生率为5.01%(20/399),本院医生组发生率为1.00%(4/400)。玻璃体脱出总发生率为3.0%。住院医师组术中并发症玻璃体脱出的发生率是本院医生组的5.22倍(P=0.002,相对危险的95%置信区间为=1.769-15.426)。结论:住院医师手法小切口白内障手术能使患者获得较好的术后视力,但在本研究中玻璃体脱出发生率较高。

AIM：To determine the visual outcome and the incidence of vitreous loss in patients undergoing manual small incision cataract surgery（MSICS） by third-year ophthalmology residents.·METHODS：Hospital records of 799 consecutive patients undergoing MSICS at Department of Ophthalmology,Prapokklao Hospital by third-year ophthalmology residents between July 2005 and June 2007 were reviewed.Best-corrected visual acuity（BCVA） were compared between the eyes operated by residents and those operated by the staffs.For the complication of vitreous loss,the study group（patients with vitreous loss） were compared with the control group（patients without vitreous loss） using analytic case-control study.·RESULTS：One month postoperatively,91.0% of patients in resident group and 92.5% in the staff group had visual acuity of 6/18 or better.The difference in visual outcome between the two groups was not statistically significant（P=0.526）.The incidence of vitreous loss among residents was 5.01%（20/399） and 1.00%（4/400） among the staff.The overall incidence of vitreous loss was 3.0%.The odds that the eyes in the resident group would have an intraoperative complication of vitreous loss were 5.22 times,the odds that the eyes in the staff group would have such a complication（P=0.002,95% confidential interval（CI） of relative risk =1.769-15.426）.·CONCLUSION：Good visual acuity can be achieved after resident perfoming MSICS.The vitreous loss rate in this study is high.