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Middle East African Journal of Ophthalmology Middle East African Journal of Ophthalmology
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Year : 2019  |  Volume : 26  |  Issue : 1  |  Page : 17-22

Improved refractive outcomes of small-incision extracapsular cataract surgery after implementation of a biometry training course

1 Fred Hollows Foundation New Zealand, Auckland; Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, New Zealand
2 Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, New Zealand
3 Pacific Eye Institute, Suva, Fiji
4 Fred Hollows Foundation New Zealand, Auckland, New Zealand

Correspondence Address:
Dr. Jay J Meyer
Department of Ophthalmology, Private Bag 92019, University of Auckland, Auckland
New Zealand
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/meajo.MEAJO_3_18

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PURPOSE: To determine whether a biometry training course could improve refractive outcomes of patients undergoing manual small-incision extracapsular cataract surgery (SICS). MATERIALS AND METHODS: This was a prospective, interventional, cohort study at the Pacific Eye Institute, Fiji. SICS refractive outcomes were evaluated before and after a structured biometry teaching course. Eyes that underwent evaluation and subsequent SICS with placement of a posterior chamber intraocular lens (IOL) were included. Axial length measurements were obtained using A-scan applanation ultrasound and keratometry with a handheld keratometer. Main outcome measures included mean absolute prediction error of IOL calculations, percentage of eyes within ±0.5 D and ±1.0 D of intended spherical equivalent, and proportion of eyes with ≥6/18 uncorrected visual acuity. RESULTS: A total of 240 eyes were analyzed: 120 eyes before and 120 eyes after the structured biometry training. The mean absolute prediction error was 50% lower following the training (1.13 ± 0.84 D pre vs. 0.56 ± 0.44 D post; P < 0.001). A higher percentage of the eyes had a postoperative spherical equivalent within ±0.5 D (26.7% pre vs. 52.5% post; P < 0.001) and ±1.0 D (55.0% pre vs. 90.0% post; P < 0.001) of the intended target. A higher proportion of the eyes achieved ≥6/18 uncorrected visual acuity (77.5% pre vs. 91.7% post, P = 0.004), while the proportion with ≥6/18 corrected visual acuity was similar (94.4% pre vs. 98.3% post; P = 0.28). CONCLUSIONS: A structured biometry training course may improve the accuracy of preoperative IOL calculations to achieve the postoperative refractive target. Ophthalmology training programs should include structured biometry teaching in their curricula.

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