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G. Jacob 1,2, C. Bouchard 2, S. Kancherla 1. Edward Hines, Jr. VA Hospital, Hines, IL, Department of Ophthalmology 1. Loyola University Medical Center, Maywood, IL, Department of Ophthalmology 2. To assesses the quality of cataract surgery by third year residents by examining their outcomes using the following parameters: 1) the accuracy of the predicted postoperative refraction (targeted at less than +/- 0.25 diopters) and 2) the change in curvature of the cornea following corneal incisions (targeted at less than 0.50 diopters). INTRODUCTION We performed a retrospective chart review of data from the cataract surgeries performed at the Hines Veterans Administration Hospital by 3 senior ophthalmology residents. The data collected included: pre-operative and post-operative keratometry measurements, visual acuity, auto refractions, manifest refractions, and IOL master or A-scan calculations using Holladay I formula for calculating post-operative spherical equivalents (SE) for specific IOL powers. Results from IOL Master and A-Scan measurements were compared. Changes in average keratometry measurements as well as changes in axis were determined 1 month after surgery. METHODS 1. Blomquist PH, et al. “Visual outcomes after vitreous loss during cataract surgery performed by residents.” J Cat Ref Surg. 28(5):847-52, May 2002. 2. Quillen DA, et al. “Visual outcomes and incidence of vitreous loss for residents performing phacoemulsification without prior planned extracapsular cataract extraction experience.” Am J Ophthalmol. 135(5):732-3, May 2003. 3. Randleman JB, et al. “Phacoemulsification with topical anesthesia performed by resident surgeons.” J Cat Ref Surg. 30(1):149-54, Jan 2004. 4. Rowden A, et al. “Resident cataract surgical training in United States residency programs.” J Cat Ref Surg. 28(12):2002-05, Dec 2002. 5. Thomas R, et al. “Visual outcome and complications of residents learning phacoemulsification.” Ind J of Ophthalmol. 45(4):215-19, 1997. REFERENCES Resident Cataract Surgery Refraction Outcomes Acknowledgements: This work was supported by Department of Veterans Affairs and The Richard A. Perritt Charitable Foundation. Author Contact Information: Gabriel Jacob M.D., gjacob@lumc.edu Comparison of Predicted vs POM#1 Results Our results indicated that the 1 month actual SE was within the target range of +/- 0.25 diopters of the predicted SE. The change in average keratometry measurement was also within the targeted range of +/- 0.50 diopters. These results will be important in the future use of premium IOLs and toric IOLs where predicted spherical equivalent and changes in astigmatism must be achieved accurately and consistently CONCLUSIONS 96 patients who underwent cataract surgery by 3 senior residents were included in the study. In comparing predicted versus actual SE using a one- sample t-test, there was a mean difference of +0.09 diopters. The 95% confidence interval was -0.04 to +0.23 diopters. The mean difference between pre-op and post-op keratometry readings was -0.11 diopters and the 95% confidence interval was -0.24 to +0.02 diopters. The mean change in axis of astigmatism was 14 degrees. RESULTS
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