June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
Comparison of Selective Laser Trabeculoplasty Outcomes Between Physicians-in-Training and Attending Physicians
Author Affiliations & Notes
  • Wanda Hu
    Jules Stein Eye Institute, Los Angeles, CA
  • Simon Law
    Jules Stein Eye Institute, Los Angeles, CA
  • JoAnn Giaconi
    Jules Stein Eye Institute, Los Angeles, CA
  • Footnotes
    Commercial Relationships Wanda Hu, None; Simon Law, None; JoAnn Giaconi, Allergan (C)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 1868. doi:
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    • Get Citation

      Wanda Hu, Simon Law, JoAnn Giaconi; Comparison of Selective Laser Trabeculoplasty Outcomes Between Physicians-in-Training and Attending Physicians. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1868.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To compare the outcomes of selective laser trabeculoplasty (SLT) performed by ophthalmology residents with those performed by glaucoma attendings in treating open angle glaucoma (OAG).

 
Methods
 

This is a retrospective review on patients with OAG (including primary OAG, pseudoexfoliation glaucoma, and pigmentary glaucoma) or OAG suspect who had received SLT performed by second year ophthalmology residents at a Veterans Affairs medical center compared to SLT performed by glaucoma attendings (JAG, SKL) at a tertiary care facility between 1/2008 and 6/2012 with at least 3 months of follow-up. Outcome measures included percent intraocular pressure (IOP) reduction, glaucoma medications, and additional glaucoma medical, laser or surgical therapy.

 
Results
 

43 eyes (43 patients) treated by residents were compared with 68 eyes (68 patients) treated by attendings with mean age of 70.3±11.8 and 69.5±11.8 years, respectively (p=0.742). Attending-treated eyes had a significantly higher proportion of primary SLT compared to resident-treated eyes (25.0% and 2.3%, respectively, p<0.001) and a smaller number of pre-operative glaucoma drops (1.6±1.3, 3.0±1.2, p<0.001) than the resident-treated eyes (Table 1). There were no significant differences between the 2 groups in percent IOP reduction from baseline at all time points after 3 months (p>0.05). 7.0% of resident-treated eyes and 13.2% of attending-treated eyes experienced an IOP spike (defined as IOP increase > 6 mmHg) within 1 hour of the procedure (p=0.315) (Table 2). There were no significant differences in the rate of additional glaucoma therapy required between attending-treated and resident-treated eyes (36.8%, 39.5%, respectively, p=0.779) and time to requiring additional therapy (14.6 ± 11.2, 14.5 ± 12.0 months, p=0.972). Attending-treated eyes received a significantly greater number of laser spots (128.3±29.7, 99.2±25.9, respectively, p<0.001), and a trend of higher total energy (108.7±29.6, 95.7±43.7, p=0.086) than resident-treated eyes.

 
Conclusions
 

SLT performed by residents at a Veterans Affairs facility had similar IOP outcomes when compared to SLT performed by attending physicians at a tertiary care center. Attending physicians tend to use SLT more as a primary treatment.

     
Keywords: 578 laser • 735 trabecular meshwork • 633 outflow: trabecular meshwork  
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