Purchase this article with an account.
Emily Marie Zepeda, Jason P Kam, Joanne C Wen, Leona Ding; Resident-performed Neodymium: YAG laser posterior capsulotomy for posterior capsule opacification. Invest. Ophthalmol. Vis. Sci. 2016;57(12):946.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To investigate power use and complication frequency of resident performed Neodymium: YAG (Nd: YAG) posterior capsulotomy and to compare power use and complication rates of residents in different stages of training.
Retrospective analysis was conducted on 175 eyes from 141 pseudophakic patients diagnosed with posterior capsule opacification (PCO) who underwent Nd: Yag posterior capsulotomy from 1/27/2010 to 11/04/2015, at Harborview Medical Center, Seattle WA by resident physicians. Data was collected on pre/post best corrected visual acuity, race/ethnicity, pre/post laser intraocular pressure (IOP), power per shot, number of shots fired and post-procedure complications. Complications included elevated post-laser IOP at 30-45 minutes (≥8mmHg), lasering structures other than the PCO, problems focusing the laser, lens subluxation and repeated procedures. Mean power use and frequency of complications were evaluated and compared between first year trainees and senior residents.
The mean total power used for all residents was 111.6 ± 91.0 mJ and the mean power per shot was 1.8 ± 2.0 mJ. The total power use for first year trainees versus senior residents (second and third year trainees) did not differ significantly (112.8 ± 87.7 mJ versus 111.1 ± 93 mJ respectively, p=0.9). The mean presenting visual acuity was LogMar 0.73 ± 0.54, (Snellen 20/107), which improved to a mean of LogMar 0.51 ± 0.51 (Snellen 20/64) post procedure. The total complication rate was 16% (28/175), including: IOP spikes in 2.3% (4/175), lasering structures other than the PCO 1.7% (3/175), problems focusing the laser in 1.7% (3/175), lens subluxation in .6% (1/175) and repeated procedures in 9.7% (17/175). The complication rates did not differ with increasing training.
The total power used and complication rates did not differ between residents in different years of training. The results of this study suggest that residents at any level of their training demonstrate procedural proficiency. The results also indicate that resident performed posterior capsulotomies are successful in improving visual acuity and have a low complication rate consistent with previously published data.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
This PDF is available to Subscribers Only