Surgical outcomes of photorefractive keratectomy and laser in situ keratomileusis by inexperienced surgeons

Abstract

Purpose To investigate the results of photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) procedures performed by novice ophthalmologists and compare the results with those of experienced refractive surgeons. Setting Doheny Eye Institute, University of Southern California, Los Angeles, and Department of Ophthalmology, University of California, Irvine, California, USA. Methods In this retrospective case series, data were examined from the first PRK procedures by 33 consecutive ophthalmologists and the first LASIK procedures by 19 consecutive ophthalmologists. Preoperative and postoperative uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA), as well as intraoperative and early postoperative complications, were recorded. Results In the PRK group, 33.3% of eyes achieved a UCVA of 20/20 and 87.8%, 20/40 or better; 54.5% were within ±0.5 diopter (D) of emmetropia and 87.8%, within ±1.0 D. Two eyes with a preoperative spherical equivalent of greater than –11.0 D lost 2 lines of BSCVA. If eyes with low myopia (≤ –6.5 D) only were included, 40.7% achieved a UCVA of 20/20 and 96.3%, 20/40 or better. In the LASIK group, 52.6% achieved a UCVA of 20/20 and 84.2%, 20/40 or better; 78.9% were within ±0.5 D of emmetropia and 89.5%, ±1.0 D. No eye in the LASIK group lost 2 or more lines of BSCVA. Conclusions Photorefractive keratectomy and LASIK are reasonably safe procedures that can be learned quickly by ophthalmic surgeons. Our data suggest that results achieved by beginning surgeons are comparable to those reported by experienced surgeons.