Initial resident refractive surgical experience: outcomes of PRK and LASIK for myopia.
OBJECTIVE
To evaluate and compare the outcome of initial resident surgical experience with photorefractive keratectomy (PRK) and LASIK.


METHODS
Retrospective review of all cases performed with the VISX Star S4 platform (Abbott Medical Optics) between July 1, 2003 and June 30, 2007. Inclusion criteria were spherical equivalent of -0.50 to -10.00 diopters (D), refractive astigmatic error of ≤3.00 D, intention to provide full distance correction, and minimum 3-month postoperative follow-up after initial ablation or retreatment (if performed).


RESULTS
A total of 153 cases performed by 20 different residents met the inclusion criteria; 38 eyes underwent PRK and 115 eyes had LASIK. After initial treatment, mean Snellen uncorrected distance visual acuity (UDVA) after PRK was 20/17.3 and after LASIK was 20/19.5. Photorefractive keratectomy was associated with a significantly better approximation between preoperative corrected distance visual acuity (CDVA) and postoperative UDVA (ΔlogMAR 0.009 vs 0.091; P=.004) and a greater percentage of eyes that achieved UDVA of 20/20 or better (94.7% vs 78.3%; P=.02) or 20/30 or better (100% vs 87.8%; P=.02). There was a higher prevalence of retreatment in eyes that underwent LASIK (7.0% vs 0%; P=.20). One (0.9%) eye lost 2 lines of CDVA after LASIK.


CONCLUSIONS
Supervised refractive surgery residents can achieve excellent visual outcomes in patients operated during their initial refractive experience. Photorefractive keratectomy was associated with better visual outcome than LASIK.
Wagoner
Michael D
MD
Department of Ophthalmology and Visual Sciences, University of Iowa Carver College of Medicine, Iowa City, IA, USA. michael-wagoner@uiowa.edu
Wickard
Joseph C
JC
Wandling
George R
GR
Milder
Lisa C
LC
Rauen
Matthew P
MP
Kitzmann
Anna S
AS
Sutphin
John E
JE
Goins
Kenneth M
KM
D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D007431:Intraoperative Complications; D020731:Keratomileusis, Laser In Situ / Q000193:education*; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000503:physiopathology / Q000601:surgery*; D009885:Ophthalmology / Q000193:education*; D018903:Photorefractive Keratectomy / Q000193:education*; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology