Sipos Timothy, Bicknell Kendall
Department of Ophthalmology, Baylor Scott & White Medical Center - Temple, Temple, Texas.
Department of Ophthalmology, Central Texas Veterans Affairs Medical Center, Temple, Texas.
Proc (Bayl Univ Med Cent). 2021 Oct 4;35(1):28-31. doi: 10.1080/08998280.2021.1982591. eCollection 2022.
To evaluate surgically induced astigmatism (SIA) in resident surgeons in their first year of performing cataract surgery, a retrospective study was conducted involving three resident physicians from July 1, 2019, to June 30, 2020. Preoperative and postoperative corneal measurements were taken with the IOLMaster 500 and Pentacam. Mean SIA and centroid were determined with the Koch-Wang Excel spreadsheet. A total of 135 eyes were operated on, with Resident A performing 67 surgeries; Resident B, 60 surgeries; and Resident C, 8 surgeries. Resident A's IOLMaster results revealed centroid values of 0.08 D @ 91° ± 0.37 diopters (D) and 0.16D @ 82° ± 0.32D and Pentacam centroid values of 0.13D @ 100° ± 0.34D and 0.24D @ 93° ± 0.38D for right and left eyes, respectively. Resident B's IOLMaster results revealed centroid values of 0.23D @ 102° ± 0.23D and 0.29D @ 110° ± 0.26D and Pentacam centroid values of 0.21D @ 124° ± 0.33D and 0.17D @ 103° ± 0.51D for right and left eyes, respectively. In conclusion, centroid values of SIA with junior surgeons were more than the proposed established values, but likely not clinically significant, with at most a difference of <0.17D in the spectacle plane. To achieve more accurate refractive outcomes in toric intraocular lenses, all residents should calculate their personal SIA early in their surgical career.
为评估住院医师在开展白内障手术的第一年中手术诱导散光(SIA)的情况,我们进行了一项回顾性研究,研究对象为2019年7月1日至2020年6月30日期间的三名住院医师。术前和术后使用IOLMaster 500和Pentacam进行角膜测量。使用Koch-Wang Excel电子表格确定平均SIA和质心。总共对135只眼睛进行了手术,住院医师A进行了67例手术;住院医师B进行了60例手术;住院医师C进行了8例手术。住院医师A的IOLMaster结果显示,右眼和左眼的质心值分别为91°时0.08 D±0.37屈光度(D)和82°时0.16 D±0.32 D,Pentacam质心值分别为100°时0.13 D±0.34 D和93°时0.24 D±0.38 D。住院医师B的IOLMaster结果显示,右眼和左眼的质心值分别为102°时0.23 D±0.23 D和110°时0.29 D±0.26 D,Pentacam质心值分别为124°时0.21 D±0.33 D和103°时0.17 D±0.51 D。总之,初级外科医生的SIA质心值高于建议的既定值,但可能无临床意义,在眼镜平面上最多相差<0.17 D。为了在散光人工晶状体中实现更准确的屈光结果,所有住院医师都应在其手术生涯早期计算个人的SIA。