Shtein Roni M, Michelotti Monica M, Kaplan Ariane, Mian Shahzad I
Department of Ophthalmology, University of Michigan, Ann Arbor, Michigan, USA.
Ophthalmic Surg Lasers Imaging. 2012 Nov-Dec;43(6):489-94. doi: 10.3928/15428877-20120920-02.
To determine effect of surgeon experience on outcomes of LASIK.
Retrospective case series of myopic femtosecond LASIK performed by residents and fellows compared to an attending surgeon, with mean follow-up of 6.6 months.
Seventy-two eyes (38 patients) had LASIK performed by a trainee and 157 eyes (83 patients) by an attending surgeon. There were no statistically significant preoperative differences. The attending surgeon had lower mean flap thickness (P = .0001), but ablation depth and residual stromal bed were similar. Postoperative uncorrected distance visual acuity was significantly better in the experienced surgeon group on the first postoperative day (P = .0203). Postoperative findings of microstriae (P < .0001) and interface debris (P = .0034) were more common with trainee-performed LASIK.
Visual outcomes are excellent after femtosecond LASIK performed by trainees and experienced surgeons. Early postoperative complications are more common in trainee-performed LASIK, but are not visually significant. Resident and fellow LASIK surgical training with a comprehensive refractive curriculum under the guidance of an experienced surgeon is safe and appropriate.
确定外科医生经验对准分子激光原位角膜磨镶术（LASIK）手术效果的影响。
对住院医师和专科住院医生与主治医生实施的近视飞秒LASIK手术进行回顾性病例系列研究，平均随访6.6个月。
72只眼（38例患者）接受了住院医生实施的LASIK手术，157只眼（83例患者）接受了主治医生实施的手术。术前无统计学显著差异。主治医生的平均角膜瓣厚度较低（P = 0.0001），但消融深度和残余基质床相似。术后第1天，经验丰富的医生组术后未矫正远视力明显更好（P = 0.0203）。住院医生实施的LASIK手术中，术后微条纹（P < 0.0001）和界面碎屑（P = 0.0034）的发生率更高。
住院医生和经验丰富的医生实施飞秒LASIK术后视力结果良好。住院医生实施的LASIK术后早期并发症更常见，但对视力影响不大。在经验丰富的医生指导下，通过全面的屈光课程对住院医生和专科住院医生进行LASIK手术培训是安全且合适的。
