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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。
Objectives: To understand the postoperative visual acuity and the incidence of vitreous prolapse in patients undergoing small incision cataract surgery by the 3a ophthalmology residency. METHODS: The medical records of 799 consecutive patients who underwent small incision cataract surgery by the first 3 a resident in Prapokklao Hospital during 2005-07 / 2007-06 were retrospectively analyzed. The best corrected visual acuity after surgery was compared between the surgical eye of the resident and the surgical eye of the doctor. For vitreous prolapse complications, we compared the study group (vitreous prolapse patients) and the control group (non-vitreous prolapse patients) using an analytical case history study. Results: At 1 month after surgery, 91% of the patients in the resident group had visual acuity> 6/18, and 92.5% in the hospitalized doctors group. There was no significant difference between the two groups (P = 0.526). The incidence of vitreous prolapse in the residents group was 5.01% (20/399) and the incidence of vitreous body in our hospital was 1.00% (4/400). The total incidence of vitreous prolapse was 3.0%. The incidence of vitreous prolapse in the residents group was 5.22 times higher than that in the hospital group (P = 0.002, 95% confidence interval was = 1.769-15.426 for the relative risk). CONCLUSIONS: Resuscitation with small incision cataract surgery by a resident can achieve better postoperative visual acuity, but the incidence of vitreous prolapse is higher in this study.