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首页> 外文期刊>International Ophthalmology >Analysis of resident-performed manual small incision cataract surgery (MSICS): an efficacious approach to mature cataracts
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Analysis of resident-performed manual small incision cataract surgery (MSICS): an efficacious approach to mature cataracts

机译：住院医师进行的手动小切口白内障手术分析（MSICS）：成熟白内障的有效方法

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摘要

To examine and improve outcomes of resident-performed manual small incision cataract surgery (MSICS) cases via analysis of visual recovery, intraoperative adverse events, and early postoperative course. Particular focus was directed toward mature cataracts extracted by MSICS. A retrospective review was performed to identify MSICS cases performed by resident surgeons unfamiliar with the technique (initial ten cases) in an academic setting. Preoperative history, intraoperative adverse events, and postoperative course were reviewed. Of 30 cases identified, mean preoperative acuity was 1.8 ± 0.9 logMAR units (Snellen equivalent = 20/1262) improving to 0.20 ± 0.35 logMAR units (20/31) at final follow-up (p 0.0001). Mean follow-up was 22.1 ± 19.0 days. The most frequent intraoperative adverse events were wound leak requiring intraoperative suturing (33 %), vitreous loss (6.7 %), and capsulorhexis radialization (6.7 %). Transient cornea edema was the most frequent (56.7 %) early postoperative minor complication. Two major complications occurred that required wound revision in one eye and iridoplasty in one eye. Of the 30 eyes undergoing surgery, 19 were noted to have mature cataracts. In this subset, mean acuity was 2.25 ± 0.64 logMAR units (20/3557) improving to 0.28 ± 0.42 logMAR (20/38) at final follow-up (p 0.0001). Complications were similar in nature and frequency to the entire population in this subgroup. Supervised resident MSICS cataract surgery can result in excellent anatomic and visual outcomes. Appropriate wound construction is a frequently encountered difficulty, so particular attention should be directed to this step by both trainers and trainees.
机译：通过分析视觉恢复，术中不良事件和术后早期病程，检查并改善住院医师进行的手动小切口白内障手术（MSICS）病例的结果。特别关注的是通过MSICS提取的成熟白内障。进行了回顾性研究，以确定在学术环境中由不熟悉该技术的住院医师进行的MSICS病例（最初为10例）。回顾了术前病史，术中不良事件和术后病程。在确定的30例病例中，术前平均视力为1.8±0.9 logMAR单位（Snellen当量= 20/1262），在最终随访时提高至0.20±0.35 logMAR单位（20/31）（p <0.0001）。平均随访时间为22.1±19.0天。术中最常见的不良事件是需要术中缝合的伤口渗漏（33％），玻璃体丢失（6.7％）和撕囊撕裂（6.7％）。短暂性角膜浮肿是术后早期轻微并发症最常见（56.7％）。发生了两个主要的并发症，需要一只眼睛进行伤口修复和一只眼睛进行虹膜成形术。在接受手术的30只眼中，有19只患有成熟的白内障。在该子集中，平均视力为2.25±0.64 logMAR单位（20/3557），在最终随访时提高至0.28±0.42 logMAR（20/38）（p <0.0001）。并发症的性质和发生频率与该亚组的总体相似。接受监督的常住MSICS白内障手术可导致出色的解剖和视觉效果。适当的伤口构造是经常遇到的困难，因此培训师和受训者都应特别注意这一步骤。

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