Resident-performed laser peripheral iridotomy in primary angle closure, primary angle closure suspects, and primary angle closure glaucoma

Jason P Kam, Emily M Zepeda, Leona Ding, Joanne C Wen Department of Ophthalmology, University of Washington, Seattle, WA, USA Purpose: To investigate the power use and complication frequency of resident-performed laser peripheral iridotomy (LPI).Methods: A retrospective analysis of 196 eyes from 1...

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Autores principales:	Kam JP, Zepeda EM, Ding L, Wen JC
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	Laser iridotomy resident complications Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/61f0dfa51d5a4e9b92a6bbb76e9cd9dc
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spelling	oai:doaj.org-article:61f0dfa51d5a4e9b92a6bbb76e9cd9dc2021-12-02T02:15:39ZResident-performed laser peripheral iridotomy in primary angle closure, primary angle closure suspects, and primary angle closure glaucoma1177-5483https://doaj.org/article/61f0dfa51d5a4e9b92a6bbb76e9cd9dc2017-10-01T00:00:00Zhttps://www.dovepress.com/resident-performed-laser-peripheral-iridotomy-in-primary-angle-closure-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Jason P Kam, Emily M Zepeda, Leona Ding, Joanne C Wen Department of Ophthalmology, University of Washington, Seattle, WA, USA Purpose: To investigate the power use and complication frequency of resident-performed laser peripheral iridotomy (LPI).Methods: A retrospective analysis of 196 eyes from 103 patients who underwent neodymium: yttrium-aluminum-garnet laser iridotomy performed by resident physicians from January 1, 2010 through April 30, 2015 at a university-based county hospital was done. All patients were treated for primary angle closure, primary angle closure suspects, and primary angle closure glaucoma. Data were collected on pre- and post-laser intraocular pressure (IOP), ethnicity, laser parameters and complications. Mean power use and frequency of complications were evaluated. Complications included elevated post-laser IOP at 30–45 minutes (≥8 mmHg), hyphema, aborted procedures, and lasering non-iris structures. The number of repeated LPI procedures, was also recorded.Results: Mean total power used for all residents was 78.2±68.7 mJ per eye. Power use by first-year trainees was significantly higher than second- and third-year trainees (103.5±75.5 mJ versus 73.7±73.8 mJ and 67.2±56.4 mJ, respectively, p=0.011). Complications included hyphema or microhyphema in 17.9% (35/196), IOP spikes in 5.1% (10/196), aborted procedures in 1.1% (3/196) and lasering non-iris structures in 0.5% (1/196). LPI was repeated in 22.4% of cases (44/196) with higher incidence of repeat LPI among non-Caucasian compared to the Caucasian subjects (p=0.02). Complication rates did not differ with increased training (p=0.16).Conclusion: Total power used for LPI decreased with increased resident training, while the complication rate did not differ significantly among resident classes. Complication rates were comparable to rates reported in the literature for attending-performed LPIs. Keywords: laser, iridotomy, resident, complications, power, energyKam JPZepeda EMDing LWen JCDove Medical PressarticleLaseriridotomyresidentcomplicationsOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 11, Pp 1871-1876 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Laser iridotomy resident complications Ophthalmology RE1-994
spellingShingle	Laser iridotomy resident complications Ophthalmology RE1-994 Kam JP Zepeda EM Ding L Wen JC Resident-performed laser peripheral iridotomy in primary angle closure, primary angle closure suspects, and primary angle closure glaucoma
description	Jason P Kam, Emily M Zepeda, Leona Ding, Joanne C Wen Department of Ophthalmology, University of Washington, Seattle, WA, USA Purpose: To investigate the power use and complication frequency of resident-performed laser peripheral iridotomy (LPI).Methods: A retrospective analysis of 196 eyes from 103 patients who underwent neodymium: yttrium-aluminum-garnet laser iridotomy performed by resident physicians from January 1, 2010 through April 30, 2015 at a university-based county hospital was done. All patients were treated for primary angle closure, primary angle closure suspects, and primary angle closure glaucoma. Data were collected on pre- and post-laser intraocular pressure (IOP), ethnicity, laser parameters and complications. Mean power use and frequency of complications were evaluated. Complications included elevated post-laser IOP at 30–45 minutes (≥8 mmHg), hyphema, aborted procedures, and lasering non-iris structures. The number of repeated LPI procedures, was also recorded.Results: Mean total power used for all residents was 78.2±68.7 mJ per eye. Power use by first-year trainees was significantly higher than second- and third-year trainees (103.5±75.5 mJ versus 73.7±73.8 mJ and 67.2±56.4 mJ, respectively, p=0.011). Complications included hyphema or microhyphema in 17.9% (35/196), IOP spikes in 5.1% (10/196), aborted procedures in 1.1% (3/196) and lasering non-iris structures in 0.5% (1/196). LPI was repeated in 22.4% of cases (44/196) with higher incidence of repeat LPI among non-Caucasian compared to the Caucasian subjects (p=0.02). Complication rates did not differ with increased training (p=0.16).Conclusion: Total power used for LPI decreased with increased resident training, while the complication rate did not differ significantly among resident classes. Complication rates were comparable to rates reported in the literature for attending-performed LPIs. Keywords: laser, iridotomy, resident, complications, power, energy
format	article
author	Kam JP Zepeda EM Ding L Wen JC
author_facet	Kam JP Zepeda EM Ding L Wen JC
author_sort	Kam JP
title	Resident-performed laser peripheral iridotomy in primary angle closure, primary angle closure suspects, and primary angle closure glaucoma
title_short	Resident-performed laser peripheral iridotomy in primary angle closure, primary angle closure suspects, and primary angle closure glaucoma
title_full	Resident-performed laser peripheral iridotomy in primary angle closure, primary angle closure suspects, and primary angle closure glaucoma
title_fullStr	Resident-performed laser peripheral iridotomy in primary angle closure, primary angle closure suspects, and primary angle closure glaucoma
title_full_unstemmed	Resident-performed laser peripheral iridotomy in primary angle closure, primary angle closure suspects, and primary angle closure glaucoma
title_sort	resident-performed laser peripheral iridotomy in primary angle closure, primary angle closure suspects, and primary angle closure glaucoma
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/61f0dfa51d5a4e9b92a6bbb76e9cd9dc
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Resident-performed laser peripheral iridotomy in primary angle closure, primary angle closure suspects, and primary angle closure glaucoma

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