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J.M. Ramocki; Evaluating Usefulness of Central Corneal Pachymetry Measurements as a Surgical Technique Assessment Tool for Supervised Resident Cataract Surgery . Invest. Ophthalmol. Vis. Sci. 2004;45(13):280.
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Purpose: We evaluated usefulness of comparing rates of postoperative increases of central corneal thickness as a surgical technique assessment tool for supervised resident cataract surgery. Methods: We prospectively measured central corneal thickness preoperatively and 24 hours postoperatively on 29 eyes of 29 patients undergoing supervised resident cataract surgery. We compared 15 operative eyes by third–year residents versus 14 eyes operated by second–year residents under more strict hands–on supervision. Eyes were also classified according to density of nucleus and phaco time: Group 1 – +2 NS and less and/or 1.5 minutes of phaco or less and Group 2 – greater than +2 NS and greater than 1.5 minutes of phaco time. Results: Of 15 eyes done by third–year residents, 13 eyes in Group 1 had an average of 27% increase in central corneal thickness postoperatively and 2 eyes in Group 2 had a 38% increase. Of 14 eyes done by second–year residents under strict hands–on supervision, 9 eyes in Group 1 had an average of 14% increase in central corneal thickness postoperatively and 5 eyes in Group 2 had a 22% increase. Conclusions: Central corneal pachymetry measurements analysis consistently showed larger increases in postoperative corneal thickness in resident surgery cases that were less well supervised, 29% (third–year cases) versus 17% (second–year cases) and cases with harder denser cataracts that required longer phaco times (38% in Group 2 versus 27% in Group 1 in third–year residents cases, 22% in Group 2 versus 14% in Group 1 in second–year residents cases). Central corneal pachymetry pre and postoperative comparisons can serve as a useful surgical technique assessment tool for supervised resident cataract surgery.
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