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Zoya Chaudhry, Andrei Dan, Rayan Alshareef, Michael A Kapusta; Does warming up influence performance and surgical outcome in epiretinal membrane peeling?. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2811.
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© ARVO (1962-2015); The Authors (2016-present)
Warming up prior to surgery has been shown to enhance performance in certain surgical disciplines such as laparoscopy. We performed a retrospective chart review to determine whether or not warming up prior to a fine motor procedure, such as an epiretinal membrane peel, will have a similar effect on surgical outcomes.
Cases were included if both the first and second cases of the day were epiretinal membrane peels and if the 2 cases were performed sequentially. The first case was the “warm-up” case and the second case was the “post warm-up” case. Baseline demographics, pre-operative characteristics, perioperative and, postoperative BCVA at 2 months and 6 months and post-operative complications were recorded. Chi-square tests, t-tests, and Fischer's exact tests were used as appropriate. Regression models were used to identify any predictors of postoperative BCVA.
54 warm-up cases and 54 post-warm-up cases were identified (108 eyes). A higher percentage of eyes in the post-warm-up group were Pseudophakic (44.4% vs. 22.2%, p=0.035). Comparing the warm-up group to the post-warm-up group, there was no significant difference between the mean pre-op BCVA (0.61 ± 0.34 vs. 0.55 ± 0.3104, p= 0.3878), post-op BCVA at 2 months (0.62 ± 0.30 vs. 0.58 ± 0.35, p= 0.56) and post-op BCVA at 6 months (0.61± 0.34 vs. 0.63 ± 0.40, p= 0.79). Linear regression models showed that only pre-op BCVA (p=0.0066) and pre-op aphakia (p=0.0056) were predictive of worse post-op BCVA. There was no significant difference between the rates of clinically significant cataracts in 6 months of follow-up between the 2 groups (p=0.52). No cases from the warm-up group and one case from the post-op group had a post-op retinal detachment.
Warming-up does not have an effect on the rate of postoperative complications or the postoperative BCVA in patients undergoing epiretinal membrane peels. The strongest predictor of post-op BCVA was pre-op BCVA. However, these results may not reflect the effect of warming up for less trained surgeons or trainees.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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