Outcomes of Laser in situ Keratomileusis in a Refractive Surgery Fellowship Program

PURPOSE: The purpose of this study was to document the learning curve and evaluate the success of laser in situ keratomileusis (LASIK) performed by fellows in a Cornea/External Disease and Refractive fellowship program. METHODS: Two surgeons performed LASIK within a fellowship training program between July 2000 and August 2001. A retrospective review was conducted to determine the visual outcomes and operative complications from this non-comparative case series of 755 consecutive eyes. All LASIK procedures were performed using a Bausch & Lomb Technolas 217A laser and the Bausch & Lomb Hansatome or the Automated Corneal Shaper microkeratome. All eyes were evaluated for operative complications. Visual acuity was reported with a minimum of 1 month follow-up. RESULTS: Data analysis revealed that uncorrected visual acuity of 20/40 or better was attained in 99.4% of treated eyes, and 20/20 or better in 77.2%. With both eyes open, 100% of patients saw 20/30 or better, 94% saw 20/20 or better, 70% saw 20/15 or better, and 5.5% saw 20/10. Flap related complications occurred in 7 of 755 eyes (0.9%) and all were successfully treated. Forty-two eyes (5.6%) were lost to follow-up prior to the 1-month examination and were excluded from analysis of visual acuity. CONCLUSIONS: Favorable operative and visual acuity 1-month results in 755 eyes after LASIK with the Bausch & Lomb Technolas 217A laser were in part due to a well organized system of education, patient examination, execution of surgery, and postoperative care. A team approach was essential.