Senior resident phacoemulsification learning cure

OBJETIVO: Analisar a curva de aprendizado dos residentes do 3o ano, com experiencia previa em microcirurgia e cirurgia intraocular, em facectomia por facoemulsificacao relacionada as complicacoes peroperatorias e ao numero de intervencoes diretas do orientador. METODOS: Foi realizada analise prospectiva de cirurgias de facectomia por facoemulsificacao realizadas durante os tres primeiros meses de treinamento do residente do 3o ano do HC FMUSP nesta tecnica. Foram registradas as complicacoes ocorridas durante o ato operatorio e a necessidade do orientador intervir diretamente na cirurgia. RESULTADOS: Foram incluidas 261 cirurgias. Destas, tiveram algum tipo de complicacao peroperatoria 30 cirurgias (11,54%). Complicacoes mais graves, com potencial para prejudicar o resultado final da cirurgia, em especial rotura de capsula posterior e perda vitrea, tiveram um indice de 8,05% e 6,13%, respectivamente. Houve necessidade de conversao para facectomia extracapsular em 3 cirurgias e de vitrectomia posterior em 2 casos. O orientador interveio diretamente na cirurgia em 11 ocasioes (4,22%), concentradas em sua grande maioria nas 40 primeiras cirurgias. CONCLUSAO: Com treinamento e supervisao adequados, taxas de complicacoes aceitaveis podem ser obtidas por residentes senior no aprendizado da facoemulsificacao. Adequada assistencia e imprescindivel para garantir o resultado das cirurgias especialmente na fase em que os residentes tem maiores taxas de complicacao, correspondente as 40 primeiras cirurgias.

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