Abstract:AIM: To investigate the methods of learning coaxial microincision phacoemulsification and assess the related complications.
METHODS:The clinical data of 1 080 eyes of coaxial microincision phacoemulsification performed by beginners from October 2011 to December 2013 was retrospectively analyzed. In order of surgery dates, the patients were equally divided into groups A, B, C and D, 270 eyes in each group. Comparisons were made among the four groups in operation time, cumulative dissipated energy(CDE), rate of intraoperative, and postoperative complications at 1d; and best corrected distance visual acuity(BCDVA)at 1mo postoperatively.
RESULTS: No significant differences were found in age, sex, lens grading, BCDVA at 1mo postoperatively among the four groups(P>0.05). The operation time was significantly longer in group A than in groups B, C and D(25.15±3.11min vs 15.20±3.40min, 14.71±3.02min and 14.41±2.91min, P<0.05). No significant differences were found in the operation time among the other three groups(P>0.05). The CDE of grade Ⅱ and Ⅲ was significantly higher in group A than that in groups B, C and D(95.9%, 97.8% and 98.5%)(P<0.01). The number of continuous curvilinear capsulorhexis(CCC)were performed successfully was significantly less in group A(80.7%)than the other three groups(95.9%, 97.8% and 98.5%)(P<0.01). The incidence of posterior capasular rupture of group A(7.8%)was higher than that of group B(3.7%), group C(1.1%)and group D(0.4%)(P<0.05), but there was no significant difference between group C and group D(P>0.05). There were no significant differences both in the number of corneal edema and BCDVA at 1d between group A and group B.(P=0.66, P=0.53).
CONCLUSION: With learning step by step, appropriate training program, careful case selection, and accurate managing complications, coxial microincision phacoemusification can be safe for a beginner.