RESUMO
Acute corneal hydrops usually resolves alone or with medical therapy along the first 4-6 weeks. However, depending on the severity of the corneal edema or the size of the Descemet break, self-healing might be difficult. Years ago, those patients had no more options than corneal transplantation, but surgical alternatives are on the rise in this century. These surgeries are becoming more popular with a variety of techniques relegating penetrating keratoplasty to a residual role. These techniques aim to accelerate corneal healing, reduce the edema, improve visual acuity and prevent from severe complications that may appear if corneal hydrops is not treated rapidly. Feasibility and safety are the favorable aspects of these techniques since the complications rates described remain low. In this review, we emphasize the recently published studies that describe both the techniques and their results.
RESUMO
Método: Se realizó un estudio retrospectivo en el cual se comparó la tasa de RCP y de complicaciones postoperatorias entre las cirugías de facoemulsifi cación realizadas por residentes antes de la implementación del protocolo quirúrgico estandarizado en años académicos 2017 a 2018 (grupo 1) con las realizadas por residentes entrenados con la aplicación sistemática del protocolo quirúrgico mejorado y estandarizado en el año académico 2019 (grupo 2) Resultados: Se analizaron los datos de 140 ojos del grupo 1, y de 125 ojos del grupo 2. Los grupos resultaron similares en edad, sexo y nivel complejidad del caso quirúrgico basado en el Royal College of Ophthalmologistes National Opthalmology Database. La tasa de RCP fue del 15% en el grupo 1 y del 4% en el grupo 2 (p= 0.003981; RR= 0.11; IC95%=0.03 - 0.45). Se observó complicación postoperatoria en 23 casos (16.4%) en el grupo 1 y en 7 casos (5.6%) en el grupo 2 (p=0.004194) Conclusión: Se observó una disminución estadísticamente signifi cativa en la incidencia de RCP en la cirugía de catarata y de complicaciones postoperatorias al implementar un protocolo de entrenamiento quirúrgico estandarizado para residentes enfocado en la facoemulsifi cación del último fragmento nuclear.
Background: Th e most common intraoperative complication in cataract surgery is posterior capsule rupture (PCR) Objective: To evaluate the impact on the incidence of PCR post cataract surgery by adding a standardized systematic to the residents surgical training protocol during phacoemulsifi cation of the last nuclear fragment. Study design: retrospective observational Method: A retrospective study was carried out in which the rate of PCR and postoperative complications was compared between phacoemulsifi cation surgeries performed by residents before the implementation of the standardized surgical protocol in academic years 2017 to 2018 (group 1) with the surgeries performed by trained residents with the systematic application of the improved and standardized surgical protocol in the academic year 2019 (group 2) Results: Data from 140 eyes in group 1 and 125 eyes in group 2 were analyzed. Th e groups were similar in age, sex, and level of complexity of the surgical case based on the Royal College of Ophthalmologists National Ophthalmology Database. Th e PCR rate was 15% in group 1 and 4% in group 2 (p = 0.003981; RR = 0.11; 95% CI = 0.03 - 0.45). Postoperative complication was observed in 23 cases (16.4%) in group 1 and in 7 cases (5.6%) in group 2 (p = 0.004194). Conclusion: A statistically signifi cant decrease in the incidence of PCR in cataract surgery and postoperative complications was observed when implementing a standardized surgical training protocol for residents focused on phacoemulsifi cation of the last nuclear fragment
