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Effect of refractive surgery experience on outcomes after photorefractive keratectomy
P J Dougherty1, R L Lindstrom, D R Hardten
1Jules Stein Eye Institute, UCLA School of Medicine, USA.
Background:
Excimer laser photorefractive keratectomy is effective in the treatment of myopia. It is unclear whether the refractive and ocular surgical experience of the surgeon influences outcome.
Methods:
Photorefractive keratectomy was performed on 131 consecutive myopic eyes by one experienced refractive surgeon and on 428 consecutive myopic eyes by six other less experienced surgeons. Outcome data were compared between groups.
Results:
The mean preoperative spherical equivalent was -5.76 +/- 2.43 diopters (D) in the single surgeon group and -5.36 +/- 2.34 D in the multiple surgeon group. Follow-up of 6 months was available on 109 eyes (83%) in the single surgeon group and 289 eyes (68%) in the multiple surgeon group. At 6 months, the average residual refractive error was +/- 0.15 +/- 1.13 D in the single-surgeon group and +0.21 +/- 1.15 D in the multiple surgeon group. This difference was not statistically significant (p = 0.68). Correction within 1 D of attempted correction was obtained in 76 eyes (70%) in the single surgeon group and in 223 eyes (77%) in the multiple surgeon group. Uncorrected visual acuity of 20/40 or better was achieved in 89 eyes (82%) in the single surgeon group and 253 eyes (88%) in the multiple surgeon group.
Conclusion:
Refractive and visual acuity outcomes after photorefractive keratectomy are influenced minimally by the refractive surgical experience of the surgeon.