Resident-Performed Phacoemulsification Cataract Surgery: Impact of Resident-Level Characteristics.

IF 1.2 Q3 OPHTHALMOLOGY
Saeed Karimi, Amir Arabi, Toktam Shahraki, Mohammad Ali Javadi, Sare Safi
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Abstract

Purpose: To evaluate the rate of complications in resident-performed phacoemulsification and influencing factors.

Methods: In this retrospective cohort study, the outcomes of cataract surgeries performed by 18 ophthalmology residents were analyzed. The outcome of first 80 phacoemulsification cataract surgeries (1440 cataract surgeries) performed by each resident were analyzed. Outcome measures included the rate of intraoperative capsular rupture requiring anterior vitrectomy, nucleus drop, and incomplete attempts at uncomplicated procedures. Changes in the rate of complications over the surgical training course were also assessed.

Results: The most common surgical complications were capsular rupture (7.5%), followed by incomplete attempt(s) (5.9%), and nucleus drop (1.1%). Comparing the first 40 and second 40 surgeries, the rate of complications decreased as a function of surgeon experience in all resident cohorts. Greater theoretical skills and younger surgeon age were associated with a lower rate of intraoperative capsular rupture (hazard ratios = 1.421 and 1.481, respectively; P = 0.047 and P = 0.041, respectively). The use of antianxiety drugs and number of surgeries in the first 6 months demonstrated no predictive value for a lower rate of intraoperative complications (hazard ratios = 0.929 and 1.002; P = 0.711 and P = 0.745, respectively).

Conclusion: The use of antianxiety medication and more surgeries in the first 6 months did not decrease the rate of intraoperative complications of phacoemulsification, while improvement of theoretical skills may have increased the safety of resident-performed cataract surgery.

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住院医师白内障超声乳化手术:住院医师水平特征的影响。
目的:探讨住院医师超声乳化术的并发症发生率及影响因素。方法:回顾性分析18例眼科住院医师白内障手术的结果。分析每位住院医师前80例(1440例)白内障超声乳化手术的结果。结果测量包括术中囊破裂的发生率,需要前玻璃体切除术,核滴,和不完整的尝试在简单的程序。在手术训练过程中,并发症发生率的变化也被评估。结果:最常见的手术并发症是囊膜破裂(7.5%),其次是未完全尝试(5.9%)和核下降(1.1%)。比较前40例和后40例手术,所有住院队列的并发症发生率随外科医生经验的增加而下降。较高的理论技能和较年轻的外科医生年龄与术中囊破裂率较低相关(风险比分别为1.421和1.481;P = 0.047, P = 0.041)。前6个月抗焦虑药物的使用和手术次数对术中并发症发生率的降低没有预测价值(风险比分别为0.929和1.002;P = 0.711, P = 0.745)。结论:抗焦虑药物的使用和前6个月手术次数的增加并没有降低超声乳化手术术中并发症的发生率,而理论技能的提高可能提高了住院医师白内障手术的安全性。
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来源期刊
CiteScore
2.50
自引率
6.70%
发文量
45
审稿时长
8 weeks
期刊介绍: Peer Review under the responsibility of Iranian Society of Ophthalmology Journal of Current Ophthalmology, the official publication of the Iranian Society of Ophthalmology, is a peer-reviewed, open-access, scientific journal that welcomes high quality original articles related to vision science and all fields of ophthalmology. Journal of Current Ophthalmology is the continuum of Iranian Journal of Ophthalmology published since 1969.
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