Phacoemulsification with topical anesthesia: Resident experience

Ünal, Mustafa; Yücel, İclal; Sarıcı, Ahmet; Artunay, Özgür; Devranoğlu, Kazım; Akar, Yusuf; Altın, Meryem

doi:10.1016/j.jcrs.2006.02.063

Cited by 70 publications

(31 citation statements)

References 31 publications

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“…70 This anterior capsular tear rate of 4% compares with other studies of conventional cataract surgery, which have demonstrated rates of 3.8% and 4.7-5.3%. 72,73 This study of FLACS also gave an overall incidence of 3.5% for PCR and 2% for posterior lens dislocation, although there was a trend towards fewer complications with time, and fewer complications among surgeons with previous experience with femtosecond lasers. 70 These figures may seem high when compared with those commonly quoted for conventional phacoemulsification.…”

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confidence: 81%

The journey to femtosecond laser-assisted cataract surgery: new beginnings or a false dawn?

Trikha

Turnbull

Morris

et al. 2013

Eye

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Femtosecond laser-assisted cataract surgery (FLACS) represents a potential paradigm shift in cataract surgery, but it is not without controversy. Advocates of the technology herald FLACS as a revolution that promises superior outcomes and an improved safety profile for patients. Conversely, detractors point to the large financial costs involved and claim that similar results are achievable with conventional small-incision phacoemulsification. This review provides a balanced and comprehensive account of the development of FLACS since its inception. It explains the physiology and mechanics underlying the technology, and critically reviews the outcomes and implications of initial studies. The benefits and limitations of using femtosecond laser accuracy to create corneal incisions, anterior capsulotomy, and lens fragmentation are explored, with reference to the main platforms, which currently offer FLACS. Economic considerations are discussed, in addition to the practicalities associated with the implementation of FLACS in a healthcare setting. The influence on surgical training and skills is considered and possible future applications of the technology introduced. While in its infancy, FLACS sets out the exciting possibility of a new level of precision in cataract surgery. However, further work in the form of large scale, phase 3 randomised controlled trials are required to demonstrate whether its theoretical benefits are significant in practice and worthy of the necessary huge financial investment and system overhaul. Whether it gains widespread acceptance is likely to be influenced by a complex interplay of scientific and socio-economic factors in years to come.

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mentioning

confidence: 81%

The journey to femtosecond laser-assisted cataract surgery: new beginnings or a false dawn?

Trikha

Turnbull

Morris

et al. 2013

Eye

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“…Nevertheless, it is important that all conditions be evaluated prior to operation in older individuals with risk factors. Topical anaesthesia is very useful for outpatients and leads to fewer post-surgical complications (21), and previous studies have described the efficacy of topical anaesthesia in outpatient operations, even when performed by residents (22)(23)(24). Koolwijk et al (25) reported that outpatient cataract surgery is easy and safe with topical anaesthesia, with minimal complications.…”

Section: Discussionmentioning

confidence: 99%

Trends in outpatient cataract surgery in the Islamic Republic of Iran, 2006-2010

Hashemi

Fotouhi

Rezvan

et al. 2016

East Mediterr Health J

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This study aimed to determine the trends in outpatient cataract surgery and its determinants in the Islamic Republic of Iran between 2006 and 2010. In this cross-sectional study, 106 cataract surgery centres were selected in all provinces by multistage randomized cluster sampling. The number of centres in each province was determined from the number of cataract operations and the number of patient charts examined in each centre was proportionate to the number of cataract operations in that centre. The prevalence of outpatient surgery increased from 46.0% (95% CI, 35.3-56.8) in 2006 to 51.4% (95% CI, 40.2-62.7) in 2010 (P = 0.549). Patients stayed in hospital for more than one night after 10.5% (95% CI, 6.9-14.1) of operations. Use of phacoemulsification and topical anaesthesia increased the prevalence of outpatient surgery and decreased intraoperative complications. Although outpatient cataract surgery increased by 11.7%, use of methods such as phacoemulsification is not widespread, and more attention should be paid to the barriers to outpatient cataract surgery in the Islamic Republic of Iran. . Les patients sont restés plus d'une nuit à l'hôpital après 10,5 % (IC à 95 %, 6,9-14,1) des opérations. Le recours à la phaco-émulsification et l'anesthésie topique faisait augmenter la prévalence de la chirurgie ambulatoire et réduisait les complications intra-opératoires. Bien que la chirurgie de la cataracte en ambulatoire ait augmenté de 11,7 %, l'utilisation de méthodes telles que la phaco-émusification n'est pas répandue, et davantage d'attention devrait être apportée aux obstacles qui s'opposent à la chirurgie de la cataracte en ambulatoire en République islamique d'Iran. 2010-‫املتوسط‬ ‫لرشق‬ ‫الصحية‬ ‫املجلة‬ ‫العرشون‬ ‫و‬ ‫الثاين‬ ‫املجلد‬ ‫التاسع‬ ‫العدد‬ 677

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“…A incidência total de complicações entre os R3 durante o aprendizado da FACO foi de 13,4%, número semelhante ao encontrado na literatura (4)(5)(23)(24)(25) .…”

Section: Discussionunclassified

“…Os programas de residência médica fazem parte do currículo de hospitais universitários. Com a disseminação do uso da facoemulsificação, o ensino desta técni-ca vem sendo inserida no programa de todos os principais centros oftalmológicos do mundo (3)(4) . As taxas de complicações durante a facoemulsificação realizadas por residentes variam na literatura de 2,0 a 14,7% (4)(5) .…”

Section: Introductionunclassified

“…Com a disseminação do uso da facoemulsificação, o ensino desta técni-ca vem sendo inserida no programa de todos os principais centros oftalmológicos do mundo (3)(4) . As taxas de complicações durante a facoemulsificação realizadas por residentes variam na literatura de 2,0 a 14,7% (4)(5) . A perda vítrea continua sendo a mais indesejada destas complicações, e estudos mostram que, olhos com perda vítrea não atingem acuidade visual esperada em muitos casos (6)(7) .…”

Section: Introductionunclassified

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Cirurgia de catarata realizada por residentes: avaliação dos riscos

Barreto¹,

Primiano

Espíndola

et al. 2010

Rev. bras.oftalmol.

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RESUMOObjetivo: Avaliar a frequência de complicações nas cirurgias de catarata realizada por residentes de um hospital universitário (segundo e terceiro anos), comparado com as realizadas por cirurgiões experientes (assistentes). Métodos: Análise retrospectiva dos prontuários de todos pacientes submetidos à cirurgia de catarata realizadas nas primeiras quinzenas de março (época do início do aprendizado da técnica cirúrgica) e de novembro (meados do aprendizado da técnica). Foram analisados a época da realização da cirurgia; graduação do cirurgião (residente ou médico assistente); técnica cirúr-gica empregada (extração extracapsular ou facoemulsificação) e a ocorrência de complicações per-operatórias e pós-operatórias. Resultados: Foram analisadas 481 cirurgias, destas, 194 (40%) foram realizadas pelos residentes do terceiro ano, 165 (34%) pelos residentes do segundo ano e 116 (26%) pelos assistentes. A complicação mais frequentemente encontrada em todas as cirurgias foi a rotura de cápsula posterior (4,8%). Não houve diferença estatisticamente significativa de complicações entre as cirurgias realizadas em março e novembro (p=0,97), bem como entre os residentes sob supervisão e os assistentes (p=0,08). Conclusão: A rotura de cápsula posterior continua sendo a complicação mais frequentemente encontrada nas cirurgias de residentes em treinamento. Não houve diferença estatisticamente significativa entre as taxas de complicação destes residentes e os assistentes, o que demonstra o importante papel de uma supervisão adequada. Descritores

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Phacoemulsification with topical anesthesia: Resident experience

Abstract: When supervised and in selected patients, residents who have no retrobulbar or peribulbar anesthesia experience can safely perform phacoemulsification using topical anesthesia.

Cited by 70 publications

References 31 publications

The journey to femtosecond laser-assisted cataract surgery: new beginnings or a false dawn?

The journey to femtosecond laser-assisted cataract surgery: new beginnings or a false dawn?

Trends in outpatient cataract surgery in the Islamic Republic of Iran, 2006-2010

Cirurgia de catarata realizada por residentes: avaliação dos riscos

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