Abstract:
We assessed risk factors for complications associated with resident-performed cataract surgery. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, we searched 4databases in September, 2023. We included peer-reviewed, full-text, English-language articles assessing risk factors for complications in resident performed cataract surgery. We excluded studies describing cataract surgeries performed by fellows, combined surgeries, and studies with insufficient information. Our initial search yielded 6244 articles; 15 articles were included after title/abstract and full-text review. Patient-related risk factors included older age, hypertension, prior vitrectomy, zonular pathology, pseudoexfoliation, poor preoperative visual acuity, small pupils, and selected types of cataracts. Surgeon-related risk factors included resident postgraduate year and surgeon right-handedness. Other risk factors included absence of supervision, long phacoemulsification time, and phacoemulsification with high power and torsion. The quality of the studies was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation; most studies graded as moderate, primarily due to risk of bias. When assigning cases to residents, graduate medical educators should consider general and resident-specific risk factors to facilitate teaching and preserve patient safety.
摘要:
我们评估与居民进行的白内障手术相关的并发症的危险因素。使用系统评价和荟萃分析指南的首选报告项目,我们在9月份搜索了4个数据库,2023年。我们包括同行评审,全文,评估居民白内障手术并发症危险因素的英文文章。我们排除了描述由研究员进行的白内障手术的研究,联合手术,和信息不足的研究。我们最初的搜索产生了6244篇文章;在标题/摘要和全文审查之后包含了15篇文章。患者相关的危险因素包括年龄较大,高血压,先前的玻璃体切除术,带状病理学,假性剥脱,术前视力差,小瞳孔,和选定类型的白内障。与外科医生相关的危险因素包括住院医师研究生和外科医生惯用右手。其他风险因素包括缺乏监督,超声乳化时间长,以及高功率和高扭转的超声乳化术。研究的质量是通过建议分级来评估的,评估,发展,和评估;大多数研究评级为中等,主要是由于偏见的风险。当把案件分配给居民时,研究生医学教育工作者应考虑一般和居民特定的风险因素,以促进教学和保护患者安全。