Advanced nurse practitioners who completed YAG capsulotomy training performed the procedure with the same rate of effectiveness as ophthalmologists in this study. Click image to enlarge.
Anti-optometry lobbyists often rely on the argument that ophthalmologists are the only medical professional with the necessary training and skill to perform certain ocular procedures such as laser surgery. This speculation has been disproven time and time again, and another recent study added to the evidence of its falsehood. The results determined that laser procedures such as YAG capsulotomy may be performed safely by other medical professionals, in this case by advanced nurse practitioners, without compromising visual outcomes or effectiveness.
The retrospective consecutive case series included 6,308 eyes of patients who received YAG posterior capsulotomies, 33.1% of which were performed by advanced nurse practitioners and 66.9% of which were performed by ophthalmologists. The median pre-op, post-op and logMAR visual acuity gain was 0.48, 0.18 and 0.30logMAR, respectively. No differences in visual outcomes were detected between patients of either group. There was also no difference in complication rate between operator training levels.
After adjusting for age, ethnicity, training grade and ocular comorbidities, the nurse practitioners had a significantly lower rate of repeat capsulotomy compared with the ophthalmologists. “Younger patients, ocular comorbidities and ophthalmology operators were associated with a higher proportion of those requiring further YAG posterior capsulotomies,” the researchers wrote in their study.
These findings concluded that not only do YAG posterior capsulotomies deliver overwhelmingly positive outcomes, but also that non-ophthalmologists can “safely and effectively contribute to various aspects of ophthalmic healthcare.”
Moussa G, Kalogeropoulos D, Ch’ng SW, et al. Comparing outcomes of advanced nurse practitioners to ophthalmologists performing posterior YAG capsulotomy, a six-year study of 6308 eyes. The Royal College of Ophthalmologists. February 28, 2022. [Epub ahead of print].