Laser Peripheral Iridotomy Curriculum: Lecture and Simulation Practical

Abstract

Introduction: Approximately 20 million people worldwide are affected by primary angle closure glaucoma, which is often treated with a laser peripheral iridotomy (LPI). In the United States, at least 60,000 to 80,000 LPIs are performed annually. However, complications can arise from improperly performed LPIs. While the Accreditation Council for Graduate Medical Education requires that all ophthalmology residents perform at least four primary LPIs prior to graduating, formal training is often lacking. In an effort to standardize LPI teaching, an LPI lecture curriculum and skills practice session were introduced. Methods: A lecture and wet-lab curriculum was developed at the University of Washington to formally teach first-year ophthalmology residents the indications and techniques for LPI. Pre-and postcurriculum knowledge was tested, and LPI performance was assessed by comparing pre-and postcurriculum total number of shots and time needed to successfully complete an LPI on a commercially available model eye. Results: The course was highly rated by 10 residents (all PGY 2), with an increase in pre-versus posttest scores, an improvement in LPI performance metrics, and an increase in preversus postcurriculum scores for the three survey questions regarding curriculum objectives. Discussion: This course improved learner knowledge and confidence in performing LPI. Test scores improved following the course, as did self-assessed confidence levels of the residents. Residents made a number of positive comments about the course. We plan to continue holding this training session every year at our institution.

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“…[3][4][5][6] However, many programs do not have a formal stepwise training program for laser education. 7 Here we present a stepwise teaching approach to glaucoma laser surgery which includes self-directed teaching modules with video instruction and affordable model eyes to simulate the surgical experience and allow residents to learn the fundamentals of laser surgery.…”