Abstract
Purpose. To determine the outcome of initial laser in situ keratomileusis (LASIK) procedures performed by anterior segment fellows in a supervised training program.
Patients and Methods. A retrospective chart review of the first 20 LASIK procedures performed by supervised anterior segment fellows at King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia, between March 1 and December 31, 2003, was conducted.
Results. During the study period, 10 anterior segment fellows each performed LASIK on 20 eyes of 10 patients. The mean spherical refractive error was -4.82 diopters (D) (range,-1.5 to -11.00 D). The mean patient age was 28.0 years (range, 18-50 years), and the follow-up period was 123.8 days (range, 14-389 days). After primary LASIK and 8 enhancement procedures (4.0%), 163 eyes (81.5%) had postoperative uncorrected visual acuity (UCVA) that was within 1 line of preoperative best spectacle corrected visual acuity (BSCVA); 194 eyes (97.0%) had postoperative UCVA that was within 2 lines of preoperative BSCVA. The difference between the mean preoperative BSCVA (20/22.25) and the postoperative UCVA (20/26.06) was -0.381 lines of Snellen acuity. Of 200 eyes, 6 eyes (3.0%) lost 2 or more lines of BSCVA. Prior to enhancement, 180 eyes (90.0%) were within 1 D of intended correction, including 14 eyes (7.0%) with undercorrection and 6 eyes (3.0%) with overcorrection. After 8 enhancements (all for undercorrection), 188 eyes (94.0%) were within 1 D of emmetropia. The incidence of intraoperative complications was 2.5%, all of which were incomplete flaps. There were no complete or buttonhole flaps. Postoperative complications occurred in 2.5% of eyes, the most serious being bilateral ectasia, which occurred in 1 patient with no preoperative evidence of keratoconus.
Conclusion. LASIK should be taught in a well-structured, supervised setting to minimize the adverse impact of complications that may occur during the early learning curve of this procedure.