Abstract

IntroductionApproximately 20 million people worldwide are affected by primary angle closure glaucoma, which is often treated with a laser peripheral iridotomy (LPI). In the United States, at least 60,000 to 80,000 LPIs are performed annually. However, complications can arise from improperly performed LPIs. While the Accreditation Council for Graduate Medical Education requires that all ophthalmology residents perform at least four primary LPIs prior to graduating, formal training is often lacking. In an effort to standardize LPI teaching, an LPI lecture curriculum and skills practice session were introduced.MethodsA lecture and wet-lab curriculum was developed at the University of Washington to formally teach first-year ophthalmology residents the indications and techniques for LPI. Pre- and postcurriculum knowledge was tested, and LPI performance was assessed by comparing pre- and postcurriculum total number of shots and time needed to successfully complete an LPI on a commercially available model eye.ResultsThe course was highly rated by 10 residents (all PGY 2), with an increase in pre- versus posttest scores, an improvement in LPI performance metrics, and an increase in pre- versus postcurriculum scores for the three survey questions regarding curriculum objectives.DiscussionThis course improved learner knowledge and confidence in performing LPI. Test scores improved following the course, as did self-assessed confidence levels of the residents. Residents made a number of positive comments about the course. We plan to continue holding this training session every year at our institution.

Highlights

  • 20 million people worldwide are affected by primary angle closure glaucoma, which is often treated with a laser peripheral iridotomy (LPI)

  • With respect to LPI performance metrics, there was a significant decrease in the total number of laser shots needed to complete an LPI total time to complete the LPI was not significantly changed

  • To teach residents LPI indications, risks, and proper LPI technique, we developed this formalized curriculum with objective measures for assessing LPI knowledge and the LPI procedure on a simulation model

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Summary

Introduction

20 million people worldwide are affected by primary angle closure glaucoma, which is often treated with a laser peripheral iridotomy (LPI). Methods: A lecture and wet-lab curriculum was developed at the University of Washington to formally teach first-year ophthalmology residents the indications and techniques for LPI. Results: The course was highly rated by 10 residents (all PGY 2), with an increase in pre- versus posttest scores, an improvement in LPI performance metrics, and an increase in preversus postcurriculum scores for the three survey questions regarding curriculum objectives. Discussion: This course improved learner knowledge and confidence in performing LPI. One-fourth of cases are due to a subtype of glaucoma called primary angle closure glaucoma (PACG).[1] Laser peripheral iridotomy (LPI) is commonly used as a treatment In an effort to standardize LPI teaching and decrease the incidence of repeat LPI, as well as to help maintain minimal complication rates, an LPI curriculum including a lecture and a skills practice session was introduced

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