Intraoperative complications of 1000 phacoemulsification procedures: A prospective study
Intraoperative complications of 1000 phacoemulsification procedures: A prospective study
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DOI：
10.1016/s0886-3350(98)80235-6
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发表时间：
1998-10-01
影响因子：
2.8
通讯作者：
Lee, BB
中科院分区：
文献类型：
--
作者：
Ng, DT;Rowe, NA;Lee, BB
目的：了解白内障囊内超声乳化术术中并发症的发生频率和性质。地点：澳大利亚悉尼达尔克罗斯私立医院和眼科、康科德医院和威尔士亲王医院。方法：本前瞻性研究纳入了前1000例由经验丰富的外科医生实施的白内障囊内超声乳化术。手术时完成一份标准化的表格。记录的数据包括存在的眼部异常、手术时间、核硬化等级和术中并发症。结果：主要并发症为后囊膜撕裂伴玻璃体丢失（1.4%）、孤立性后囊膜撕裂（0.7%）和带裂（0.1%）。次要并发症包括前囊撕裂（3.8%）、虹膜脱垂（0.6%）和睫状体切口（0.2%）。随着核硬化级别的增加，有明显的并发症趋势。前150例主要并发症发生率为9.3%，后850例为0.9%。这表示前150例与后850例相比，发生主要并发症的相对风险为9.9（95%可信区间4.2至23.0）。结论：前150次手术后大、小并发症发生率明显下降，并保持稳定。本研究可为新手超声乳化手术提供指导，并为有经验的外科医生比较其手术效果提供依据。
Purpose: To determine the frequency and nature of intraoperative complications of endocapsular phacoemulsification cataract surgery.Setting: Dalcross Private Hospital and the Departments of Ophthalmology, Concord Hospital and Prince of Wales Hospital, Sydney, Australia.Methods: This prospective study included the first 1000 cases of planned endocapsular phacoemulsification cataract surgery performed by an experienced surgeon. A standardized proforma was completed at the time of surgery. Data recorded included pie-existing ocular abnormalities duration of surgery, nuclear sclerosis grade, and intraoperative complications.Results: Major complications comprised posterior capsule tears with vitreous loss (1.4%) isolated posterior capsule tears (0.7%), and zonulysis (0.1%). Minor complications included anterior capsule tears (3.8%), iris prolapse(0.6%), and ciliary body incision (0.2%). There was a significant trend toward complications as the nuclear sclerosis grade increased. The incidence of major complications was 9.3% in the first 150 cases and 0.9% in the last 850. This represents relative risk of 9.9 (95% confidence interval 4.2 to 23.0) of a major complication occurring in the first 150 compared with the later 850 cases.Conclusion: The frequency of major and minor complications fell sharply after the first 150 operations and was maintained. This study may provide a guide for beginning phacoemulsification surgeons and a basis for experienced surgeons to compare their performance outcomes.