| Clinical Results of Posterior Capsule Ruptures in the First 1000 Phacoemulsification Cases. |
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Un Chul Park, Ji Won Kwon, Young Keun Han |
1Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea. eye129@paran.com
2Seoul Artificial Eye Center, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.
3Department of Ophthalmology, Seoul National University Boramae Hospital, Seoul, Korea. |
| 수정체유화술 초심자의 첫 1000예에서 발생한 후낭 파열의 임상양상 |
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박운철1,2,권지원1,2,한영근1,2,3 |
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Department of Ophthalmology, Seoul National University College of Medicine1, Seoul, Korea Seoul Artificial Eye Center, Clinical Research Institute, Seoul National University Hospital2, Seoul, Korea Department of Ophthalmology, Seoul National University Boramae Hospital3, Seoul, Korea |
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Correspondence:
Un-Chul Park, M.D.1,2 |
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| Abstract |
PURPOSE
To analyze the results of posterior capsule rupture (PCR) that occurred in the first 1000 cases performed by a newly trained phacoemulsification surgeon. METHODS: The medical records of 47 eyes of 45 patients who suffered PCR among the first 1000 cases of cataract surgery performed by one newly trained surgeon were reviewed. All surgeries started with the plan of phacoemulsification and there was no supervision by any experienced surgeon. RESULTS: Over the course of the series of 1000 cases, the PCR incidence rate steadily fell from 12% in the first 100 cases to 4.7% (47 cases) for all 1000 cases as the operator gained experience with the techniques. However, after the change of phaco machine and the technique of nucleus removal, the incidence increased abruptly to 11% and then decreased again. There was no significant difference in PCR incidence between surgeries of the first eye and the second eye of the 335 patients who underwent cataract surgery in both eyes by the surgeon (p=0.534). PCR occurred most commonly in the course of phacoemulsification (83.0%) and mainly in the eyes with severe nucleus sclerosis. CONCLUSIONS: In the early stages of the career of a phacoemulsification surgeon, the PCR incidence showed a learning curve that decreased with increasing experiences, then it increased again after the change of operational procedure before finally decreasing once more. In the surgery of the second eye, poor patient cooperation could be overcome with a careful approach, and PCR occurred most commonly in the course of phacoemulsification (83.0%). |
| Key Words:
Learning curve;Phacoemulsification beginner;Posterior capsule rupture |
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