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Comparison of Posterior Capsule Rupture Rate during Phacoemulsification by Novice Ophthalmologists: Microscope vs. Intracameral Illumination
초심자 안과 전문의가 시행한 수정체유화술 중 발생한 후낭파열빈도: 현미경 조명과 안구내 조명
JKOS 2019 Jul;60(7):654-60
Published online July 15, 2019;
Copyright © 2019 The Korean Ophthalmological Society.
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Yu Jeong Kim, MD1, Hyejin Seo, MD2, Jong Hwan Lee, MD1, Seong-Woo Kim, MD, PhD3, Tae-Young Chung, MD, PhD4, Sung Jin Lee, MD, PhD5, Kyu Hyung Park, MD, PhD6, Dong Heun Nam, MD, PhD1

Department of Ophthalmology, Gachon University Gil Hospital1, Incheon, Korea
DMC Good Eye Clinic2, Seoul, Korea
Department of Ophthalmology, Korea University Guro Hospital3, Seoul, Korea
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine4, Seoul, Korea
Department of Ophthalmology, Soonchunhyang University Seoul Hospital5, Seoul, Korea
Department of Ophthalmology, Seoul National University Bundang Hospital6, Seongnam, Korea
가천대학교 길병원 안과학교실1, DMC 조은안과2, 고려대학교 구로병원 안과학교실3, 성균관대학교 의과대학 삼성서울병원 안과학교실4, 순천향대학교 서울병원 안과학교실5, 서울대학교 분당서울대학교병원 안과학교실6
Received December 27, 2018; Revised February 24, 2019; Accepted June 25, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: We compared the posterior capsule rupture (PCR) rate between microscope versus intracameral illumination in phacoemulsification surgery performed by novice ophthalmologists.
Methods: We conducted a retrospective chart review of 300 eyes of 211 patients who underwent phacoemulsification by novice ophthalmologists from March 2012 to October 2017. Novice ophthalmologists (n = 6) were divided into those using microscope illumination (n = 4) and intracameral illumination users (n = 2). The first 50 cataract surgery cases of each novice ophthalmologist were reviewed. The results using a phacoemulsification machine and microscopy were the same. The intraoperative complications and learning curve in each case were evaluated.
Results: Phacoemulsifications performed by novice ophthalmologists showed a statistically significant difference in PCR rate between the microscope illumination (19.0%, 38/200) and intracameral illumination (4.0%, 4/100) groups (p = 0.001). The incidence of PCR was reduced to 22%, 18%, 16%, 12%, and 8% per 10 cases in the microscope group, while it was 15% in the first 10 cases and 0% in 50 cases thereafter in the intracameral illumination group.
Conclusions: Novice surgeons had a lower PCR rate during cataract surgery using intracameral illumination than using microscope illumination. Both groups showed a tendency for the PCR to decrease with increasing surgical cases, but the intracameral illumination group showed a shorter learning curve.
Keywords : Intracameral illumination, Learning curve, Novice ophthalmologist, Phacoemulsification, Posterior capsule rupture


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