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Varesh Patel, Elliot S Crane, Marco A Zarbin, Neelakshi Bhagat; Resident Performed Pan-Retinal Photocoagulation. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5984. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To report anatomic and functional outcomes of resident performed pan-retinal photocoagulation (PRP).
This is a retrospective cohort study of subjects that underwent PRP by ophthalmology residents for proliferative retinopathy (PR) at Institute of Ophthalmology and Visual Science, Rutgers New Jersey Medical School. Patients underwent their first PRP between July 1, 2011 and June 30, 2015 and had ≥ six months follow up. Best-corrected visual acuity (BCVA) was collected at regular intervals and converted to modified logMAR notation for calculations. Analysis was done using Microsoft Excel.
Of 1000 patients identified, 158 met inclusion criteria (224 eyes) with a mean ± standard deviation (SD) age of 53±12 years. 61% were male, 75% had hypertension, and 94% had diabetes mellitus. The indications for PRP varied, with 92% of the eyes having proliferative diabetic retinopathy (PDR), 1.9% central retinal vein occlusion-related PR, 3.2% branch retinal vein occlusion-related PR, 2.5% sickle cell retinopathy-related PR, and 0.6% persistent rubeosis. Of those patients with PDR, 53% had insulin dependent DM, with a mean ± SD HbA1c of 8.7±2.3. Pre-operative lens status for the 224 eyes varied: phakic (90%), posterior chamber intraocular lens (IOL, 8.4%), aphakic (0.45%), anterior chamber IOL (0.45%), and sulcus IOL (0.45%). The mean ± SD number of PRP sessions and laser spots within six months was 2.4±1.2 and 1582±970, respectively. The mean ± SD logMAR BCVA for pre-operative, six months post-operative, and last visit were 0.79±0.62, 0.96±0.75 and 1.06±0.88, respectively. Prior to PRP, 12.1% of patients had neovascularization of the iris (NVI), 13.4% had diabetic retinal detachment (RD), 51.8% had vitreous hemorrhage (VH), and 1.3% had undergone pars plana vitrectomy (PPV). Within six months of their PRP, of the patients without these conditions previously, 7.6% developed NVI, 12.8% developed RD, 16.8% developed VH, and 15.4% needed PPV.
The anatomic and functional outcome of eyes that underwent PRP laser for proliferative retinal disorders by ophthalmology residents-in-training in this study were similar to what is reported in the literature for fellowship trained retina specialists.
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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