Safety and Efficacy of Resident-Performed Refractive Laser–Assisted Cataract Surgery

Sunday, April 19, 2015: 2:01 PM
Room 5B (San Diego Convention Center)
Reid Turner, MD
Lynn Perry, MD, PhD

To compare surgical complications and visual acuity outcomes of resident performed refractive laser assisted cataract surgery (ReLACS) with resident performed phacoemulsification cataract surgery at one teaching institution.

A retrospective chart review was conducted. 33 eyes undergoing resident performed ReLACS with use of the Catalys Precision Laser System (Optimedica) and 41 eyes undergoing standard phacoemulsification cataract surgery without use of the laser from September 2013 to July 2014 were included. All cases were performed by 3rd year residents with attending supervision at the Storm Eye Institute in Charleston, South Carolina. The Catalys laser was used to create the anterior capsulotomy and lens fragmentation in all 33 laser cases. Pre-operative characteristics, surgical complications, cumulative dissipated energy (CDE), and visual acuity data were compared.

Pre-operative characteristics including age, gender, best corrected visual acuity, and nuclear sclerotic cataract grade did not significantly differ. One patient in the ReLACS group experienced iris prolapse related to intraoperative floppy iris syndrome, whereas there were no surgical complications in the standard surgery group (p=0.32). The CDE range for ReLACS patients versus the standard surgery group was 0.53-29.13 (mean=9.6) and 1.88-73.55 (mean=19.1) respectively (p=0.0085). The mean one month post-operative best corrected visual acuity achieved was 20/27 in the ReLACS group and 20/32 in the standard surgery group (p=0.57).

Resident performed ReLACS appears equally safe and efficacious when compared to standard phacoemulsification surgery. CDE was significantly lower which may improve patient outcomes. Further study is needed to identify possible clinically significant benefits of resident performed ReLACS to further warrant its place in residency training.