조명챠퍼를 이용한 Phaco Chop 백내장수술의 학습곡선
Learning Curve in Phaco Chop Cataract Surgery Using an Illuminated Chopper
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목적: 조명챠퍼(illuminated chopper [iChopper]; Oculight, Seongnam, Korea)를 이용한 phaco chop 방법으로 백내장수술 합병증을줄이고, phaco chop을 처음 시작하는 술자도 안전하고 효과적인 phaco chop을 할 수 있음을 확인하고자 하였다. 대상과 방법: 4인의 안과 전문의가 조명챠퍼를 이용하여 phaco chop을 처음 시작한 시점으로부터 각 30안씩, 총 120안의 의무기록을후향적으로 분석하였다. 4인의 안과 전문의 술자는 phaco chop을 시작하기 이전에 10,000예 이상의 백내장수술 경험이 있는 숙련자부터 20예의 백내장수술 경험의 초심자까지 다양한 경험적 배경을 갖고 있었다. 결과: 총 120안 중 후낭파열이 발생한 안은 2안(1.67%)이었다. 3안(2.5%)에서는 phaco chop에서 stop and chop으로 변경하였는데1안은 거짓비늘증후군을 동반한 갈색백내장을 진단받은 안이었고, 2안은 핵경화도가 5 이상인 안이었다. 결론: 다양한 경험의 4인의 술자들이 조명챠퍼를 사용하여 단기간에 수정체핵쪼개기에 능숙하게 되었으며, 매우 낮은 후낭파열 비율을 보였다.
Abstract
Purpose: To confirm that the phaco chop method using an illuminated chopper (iChopper; Oculight, Seongnam, Korea) can reduce cataract surgery complications, and that even beginners can safely and effectively perform phaco chop. Methods: We retrospectively analyzed the medical records of the first 30 phaco chop cases using illuminated chopper of four cataract surgeons. Four ophthalmologists had a variety of empirical backgrounds, from those who have experienced more than 10,000 cataract surgery, to beginners who have experienced 20 cataract surgery. Results: Of the total 120 eyes, two eyes (1.67%) had posterior capsule rupture. The chopping method was changed from phaco chop to stop and chop in three eyes (2.5%) including one eye with brown cataract with pseudoexofoliation syndrome and two eyes with nuclear opacity grade ≥5. Conclusions: The rates of posterior capsule rupture of phaco chop using an illuminated chopper were very low in four surgeons with various experiences and who became proficient shortly in phaco chop.
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