Transcript Resident Cataract Surgery Refraction Outcomes G. Jacob1,2, C. Bouchard2, S. Kancherla1.

Resident Cataract Surgery Refraction Outcomes
G. Jacob1,2, C. Bouchard2, S. Kancherla1. Edward Hines, Jr. VA Hospital, Hines, IL, Department of Ophthalmology1.
Loyola University Medical Center, Maywood, IL, Department of Ophthalmology2.
Comparison of Predicted vs POM#1 Results
INTRODUCTION
METHODS
We performed a retrospective chart review of data from the cataract
surgeries performed at the Hines Veterans Administration Hospital by 3
senior ophthalmology residents. The data collected included: pre-operative
and post-operative keratometry measurements, visual acuity, auto
refractions, manifest refractions, and IOL master or A-scan calculations
using Holladay I formula for calculating post-operative spherical equivalents
(SE) for specific IOL powers. Results from IOL Master and A-Scan
measurements were compared. Changes in average keratometry
measurements as well as changes in axis were determined 1 month after
surgery.
Spherical Equivalent
To assesses the quality of cataract surgery by third year residents by
examining their outcomes using the following parameters: 1) the accuracy of
the predicted postoperative refraction (targeted at less than +/- 0.25 diopters)
and 2) the change in curvature of the cornea following corneal incisions
(targeted at less than 0.50 diopters).
CONCLUSIONS
POM#1 Difference in Predicted vs Actual
Spherical Equivalent
Our results indicated that the 1 month actual SE was within the target range of
+/- 0.25 diopters of the predicted SE. The change in average keratometry
measurement was also within the targeted range of +/- 0.50 diopters. These
results will be important in the future use of premium IOLs and toric IOLs
where predicted spherical equivalent and changes in astigmatism must be
achieved accurately and consistently
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REFERENCES
1. Blomquist PH, et al. “Visual outcomes after vitreous loss during cataract surgery
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performed by residents.” J Cat Ref Surg. 28(5):847-52, May 2002.
2. Quillen DA, et al. “Visual outcomes and incidence of vitreous loss for residents
performing phacoemulsification without prior planned extracapsular cataract
extraction experience.” Am J Ophthalmol. 135(5):732-3, May 2003.
3. Randleman JB, et al. “Phacoemulsification with topical anesthesia performed by
resident surgeons.” J Cat Ref Surg. 30(1):149-54, Jan 2004.
4. Rowden A, et al. “Resident cataract surgical training in United States residency
programs.” J Cat Ref Surg. 28(12):2002-05, Dec 2002.
5. Thomas R, et al. “Visual outcome and complications of residents learning
phacoemulsification.” Ind J of Ophthalmol. 45(4):215-19, 1997.
Resident
POM#1 Avg Change in Keratometry
RESULTS
96 patients who underwent cataract surgery by 3 senior residents were
included in the study. In comparing predicted versus actual SE using a onesample t-test, there was a mean difference of +0.09 diopters. The 95%
confidence interval was -0.04 to +0.23 diopters. The mean difference between
pre-op and post-op keratometry readings was -0.11 diopters and the 95%
confidence interval was -0.24 to +0.02 diopters. The mean change in axis of
astigmatism was 14 degrees.
Avg Keratometry
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Acknowledgements: This work was supported by Department of Veterans Affairs and
The Richard A. Perritt Charitable Foundation.
Author Contact Information:
Gabriel Jacob M.D., [email protected]