Polina Lankry1, Anat Loewenstein1,2, Elad Moisseiev3,4. 1. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. 2. Department of Ophthalmology, Tel Aviv Medical Center, Tel Aviv, Israel. 3. Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel, elad_moi@netvision.net.il. 4. Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel, elad_moi@netvision.net.il.
Abstract
OBJECTIVE: To compare the outcomes of laser retinopexy for the treatment of retinal tears between residents and specialists, and to identify tear characteristics associated with the risk of progression to retinal detachment (RD). METHODS: A retrospective review of 307 eyes treated by laser retinopexy, categorized by the performing physician, either a resident (217 cases) or a specialist (90 cases). Recorded parameters included the number, size, and location of the retinal tears, the presence of bridging vessels, vitreous hemorrhage (VH), or subretinal fluid (SRF), the need for additional laser, progression to RD, and surgery. RESULTS: Additional laser was performed in 42.3% of cases in the resident group and 35.5% in the specialist group (p = 0.26). Progression to RD occurred in 6.9% of cases in the resident group and 5.5% in the specialist group (p = 0.66). The presence of VH and SRF were associated with an increased risk of progression to RD (p < 0.0001 and 0.003, respectively). A higher proportion of cases with SRF were treated by specialists (p = 0.006). CONCLUSIONS: Laser retinopexy is safely and effectively performed by residents, with no worse outcomes than procedures performed by specialists. A high rate of additional laser may be needed to achieve RD prophylaxis, and higher-risk cases can be identified at presentation and then referred to specialists.
OBJECTIVE: To compare the outcomes of laser retinopexy for the treatment of retinal tears between residents and specialists, and to identify tear characteristics associated with the risk of progression to retinal detachment (RD). METHODS: A retrospective review of 307 eyes treated by laser retinopexy, categorized by the performing physician, either a resident (217 cases) or a specialist (90 cases). Recorded parameters included the number, size, and location of the retinal tears, the presence of bridging vessels, vitreous hemorrhage (VH), or subretinal fluid (SRF), the need for additional laser, progression to RD, and surgery. RESULTS: Additional laser was performed in 42.3% of cases in the resident group and 35.5% in the specialist group (p = 0.26). Progression to RD occurred in 6.9% of cases in the resident group and 5.5% in the specialist group (p = 0.66). The presence of VH and SRF were associated with an increased risk of progression to RD (p < 0.0001 and 0.003, respectively). A higher proportion of cases with SRF were treated by specialists (p = 0.006). CONCLUSIONS: Laser retinopexy is safely and effectively performed by residents, with no worse outcomes than procedures performed by specialists. A high rate of additional laser may be needed to achieve RD prophylaxis, and higher-risk cases can be identified at presentation and then referred to specialists.
Authors: George Moussa; Emma Samia-Aly; Soon Wai Ch'ng; Kim Son Lett; Arijit Mitra; Ajai K Tyagi; Ash Sharma; Walter Andreatta Journal: Eye (Lond) Date: 2021-05-25 Impact factor: 4.456
Authors: George Moussa; Emma Samia-Aly; Soon Ch'ng; Kim Son Lett; Arijit Mitra; Ajai K Tyagi; Ash Sharma; Walter Andreatta Journal: BMJ Open Ophthalmol Date: 2022-02-04