Abstract
Purpose :
To evaluate postoperative visual outcomes in patients treated with photoablative refractive surgery, including photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK), at a teaching institution with trainee involvement in preoperative planning.
Methods :
This is a retrospective chart review of patients (age 22 to 57) treated with photoablative refractive surgery, including PRK and LASIK, from 11/2/2018 to 3/29/2021 at Cook County Health. Preoperative evaluation, surgery, and postoperative visits were conducted for each patient. All cases with trainee involvement were supervised by an attending surgeon. Follow-up examinations were performed at 1 day, 1 week, 1 month, and 3 months or greater postoperatively. The primary outcome measure is final postoperative visual acuity at 3 months or greater.
Results :
147 eyes of 74 patients were evaluated. 89 eyes were treated with PRK and 58 eyes were treated with LASIK. Average preoperative spherical equivalent was -3.63D (range -8.75D to +5.50D). Final postoperative uncorrected visual acuity (UCVA) of 20/25 or better was seen in 90.48% of eyes (133 of 147 total eyes). UCVA of 20/25 or better was achieved in 93.18%, 89.47%, and 89.13% of eyes that were preoperatively evaluated by resident trainees (RES), cornea-refractive fellow trainees (FEL), and attending surgeons (ATT), respectively. When separated by type of procedure, eyes that were preoperatively evaluated by the RES group achieved UCVA of 20/25 or better in 93.94% and 90.91% in the PRK and LASIK groups, respectively. Five eyes required postoperative enhancements - 3 out of 44 from the RES group, 0 out of 57 from the FEL group, and 2 out of 46 from the ATT group. No patients had significant postoperative complications.
Conclusions :
Residents and fellows can safely and effectively be involved in preoperative planning for photoablative refractive surgery with excellent outcomes, comparable to that of attendings.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.