ISTANBUL escrs

Surgeon characteristics associated with adverse events in corneal transplantation

Session Details

Session Title: Cornea
Session Date/Time: Sunday 22/02/2015 | 08:30-11:00
Paper Time: 09:51
Venue: Hall 2
First Author: : S.Mian USA
Co Author(s): :                  

Abstract Details

Purpose:

To assess surgeon characteristics associated with reported adverse events in penetrating keratoplasty (PK) and descemet's stripping automated endothelial keratoplasty (DSAEK) during the early postoperative period.

Setting:

Midwest Eyebanks, Michigan Eye Bank. 4889 Venture Dr, Ann Arbor, MI 48108, USA

Methods:

We compared surgeon characteristics for corneal tissues used in PK and DSAEK between 2007 and 2011 including tissues with reported adverse events. Sub-group analysis was performed to evaluate for surgeon-related adverse events, defined as those due to surgeon inexperience or intraoperative complications.

Results:

Of 13,550 tissues included, there were 204 (1.51%) reported adverse events – 135 in DSAEK and 69 in PK. The adverse event rate was 0.90% in PK versus 2.29% in DSAEK. DSAEK surgeons were more likely to be fellowship trained (P=0.04) and work in cornea sub specialty practices (P=0.02) than PK surgeons. Both overall and surgeon-related adverse event rates were significantly higher in DSAEK compared to PK (P<0.0001). Surgeons working in cornea sub specialty practices had lower adverse event rates (P=0.02 in DSAEK, P=0.01 in PK). Lower surgeon-related adverse events were also associated with greater surgeon experience (P=0.04) in DSAEK.

Conclusions:

The rate of reported adverse events was low. Overall and surgeon-related adverse events were more common after DSAEK. A small number of high-volume surgeons account for a large proportion of all surgeries. While greater surgeon experience was associated with lower adverse events in DSAEK, the effect was minimal once a surgeon had performed at least ten cases a year.

Financial Disclosure:

NONE

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