Effectiveness of emergency argon laser retinopexy performed by trainee doctors
Y K Ghosh1, S Banerjee, A K Tyagi
1Department of Vitreo-retinal Surgery, Birmingham & Midland Eye Centre City Hospital, NHS Trust, Dudley Road, Birmingham B17 7QU, UK.
Objective:
To report the outcomes following treatment of retinal tears with argon laser photocoagulation by trainee doctors as an emergency procedure.
Methods:
Retrospective, case note analysis of 100 consecutive patients treated between August 2000 and December 2002 at a tertiary referral hospital.
Results:
The case notes of 100 consecutive patients (41 male, 59 female) with a mean age of 57.5 years were reviewed. Out of these 90 were symptomatic. The follow-up period ranged from 1 week to 8 months. All patients had argon laser retinopexy in the Emergency department. The on-call Registrar performed the procedure on 94 patients, and Senior House Officers performed the other six. A total of 98 procedures were performed on the slit lamp and two by laser indirect ophthalmoscope. In all, 24 patients needed further treatment with either indirect laser, cryotherapy, or surgery. At the last follow-up, all the patients had anatomically attached retinas.
Conclusion:
A significant proportion of patients (24%) undergoing laser retinopexy in the emergency department needed further treatment. The relative inexperience in using the indirect laser, together with its unavailability in the Emergency department, may be the contributory factors. There seems to be scope for supervised training in using the laser indirect ophthalmoscope for the trainees in the Ophthalmic Emergency department.
