Abstract
Purpose :
Previous studies have demonstrated favorable outcomes of cataract surgery with toric intraocular lens (IOL) implantation performed by resident physicians. We performed a retrospective cohort study to directly compare resident toric IOL surgery outcomes to those of attending physicians to determine if outcomes were similar.
Methods :
Data were reviewed from 2014-18 for all patients who received toric IOL surgery at the Veteran Affairs Tennessee Valley Healthcare System (VA TVHS). 8 cases were excluded due to missing data. Primary outcomes were postoperative refractive spherical equivalent (SE) and residual cylinder in diopters (D) and visual acuity converted to logMAR at 1 year follow up or at 30 days if patient did not have further follow up.
Results :
Of the 139 surgeries, 37 were performed by attendings and 102 by residents. Attending and resident patients were of similar age and sex. Resident cases lasted significantly longer (40 min) than attending cases (24 min, p < 0.001). Resident cases also used toric lenses of higher cylinder power (MED = 3.00, MOD = 2.25) than attending cases (MED = 2.25, MOD = 1.5, p < 0.001). Postoperative visual acuity of resident cases (MED = 0.00, IQR = [-0.00, 0.10]) was not significantly different from attending cases (MED = 0.10, IQR = [-0.00, 0.10], p = 0.423). Refractive SE for resident cases (M = -0.30D SD = 0.51) was not significantly different from attending cases (M = -0.37D SD = 0.50, p = 0.505). Residual cylinder also did not show significant difference between resident cases (MED = 0.75D, IQR = [0.25, 1.25]) and attending cases (MED = 0.75D, IQR = [0.50, 1.25], p = 0.311).
Conclusions :
Although resident surgeries took longer and used higher cylinder power toric lenses, the outcomes measured were not significantly different between attending and resident performed cases. This suggests that the outcomes of resident toric cases are similar to those of attending physicians.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.