Sources of Medical Error in Refractive Surgery

Moshirfar, Majid; Simpson, Rachel G.; Dave, Sonal B.; Christiansen, Steven M.; Edmonds, Jason N.; Culbertson, William W.; Pascucci, Stephen E.; Sher, Neal A.; Cano, David B.; Trattler, William B.
May 2013
Journal of Refractive Surgery;May2013, Vol. 29 Issue 5, p303
Academic Journal
PURPOSE: To evaluate the causes of laser programming errors in refractive surgery and outcomes in these cases. METHODS: In this multicenter , retrospective chart review, 22 eyes of 18 patients who had incorrect data entered into the refractive laser computer system at the time of treatment were evaluated. Cases were analyzed to uncover the etiology of these errors, patient follow-up treatments, and final outcomes. The results were used to identify potential methods to avoid similar errors in the future. RESULTS: Every patient experienced compromised uncorrected visual acuity requiring additional intervention, and 7 of 22 eyes (32%) lost corrected distance visual acuity (CDVA) of at least one line. Sixteen patients were suitable candidates for additional surgical correction to address these residual visual symptoms and six were not. Thirteen of 22 eyes (59%) received surgical follow-up treatment; nine eyes were treated with contact lenses. After follow-up treatment, six patients (27%) still had a loss of one line or more of CDVA. Three significant sources of error were identified: errors of cylinder conversion, data entry, and patient identification error. CONCLUSION: Twenty-seven percent of eyes with laser programming errors ultimately lost one or more lines of CDVA. Patients who underwent surgical revision had better outcomes than those who did not. Many of the mistakes identified were likely avoidable had preventive measures been taken, such as strict adherence to patient verification protocol or rigorous rechecking of treatment parameters.


Related Articles

  • ENHANCING CATARACT REFRACTIVE SURGERY EVERY STEP OF THE WAY.  // Ophthalmology Times;5/15/2014, Vol. 39 Issue 10, p2 

    The article presents the insights of experts on how the VERIONTM Image Guided System targets and addresses sources of refractive error and enhances accuracy and efficiency during cataract refractive surgery.

  • AMO acquires WaveFront Sciences. Webb, Jennifer A. // Ophthalmology Times;2/1/2007, Vol. 32 Issue 3, p6 

    The article reports on the acquisition made by Advanced Medical Optics Inc. (AMO) on WaveFront Sciences Inc. in Albuquerque, New Mexico for the custom all-laser LASIK. Sources say that it will give AMO proprietary technologies it hopes will accelerate next-generation diagnostics for refractive...

  • Correcting refractive error. Tuft, Stephen // GP: General Practitioner;9/22/2006, p35 

    The article presents information related to the refractive errors of the eye. The refractive errors can be correct by laser surgery. The risks in laser surgery are less. In practice laser surgery is sometimes necessary to correct residual refractive error. The data regarding the safety and...

  • Refractive Surgery. Halliday, B.L. // British Medical Journal (Clinical Research Edition);10/31/1987, Vol. 295 Issue 6606, p1081 

    Focuses on the different eye error surgery. Enumeration of eye treatment techniques; Development of excimer laser and lenses for refractive surgery; Classification of refractive surgery as major surgery.

  • One-third of people over 40 have vision disturbances.  // New York Amsterdam News;5/13/2004, Vol. 95 Issue 20, p33 

    Refractive errors, or inability of the eye to focus properly, affect about one-third of people 40 years and older in the U.S. and Western Europe, and one-fifth of Australians 40 or older, according to an article in the Archives of Ophthalmology, one of the journals of the American Medical...

  • Seeing beyond the PR of refractive surgery. Moriarty, Anthony // Pulse;3/31/2003, Vol. 63 Issue 13, p56 

    Provides information about the uses of refractive eye surgery in Great Britain. Techniques used for correcting refractive errors; Qualifications of the surgeons in performing refractive surgery; Need to choose the right refractive eye surgeon.

  • Knowledge in refractive surgery among medical students State University of Londrina. Gameiro Filho, Aluisio Rosa; de Aquino, Nathalia Mayumi Thomaz; de Arruda Pacheco, Eliana Barreiros; Taba Oguido, Ana Paula Miyagusko; Barbante Casella, Antonio Marcelo // Revista Brasileira de Oftalmologia;May/Jun2013, Vol. 72 Issue 3, p172 

    Objective: Evaluate the knowledge of medical students from Universidade Estadual de Londrina (UEL), about refractive surgery, as well as analyzing the percentage of students that presents refractive errors, their correction methods and their interest (or not) in the surgical procedure. Methods:...

  • Patient age, refractive error determine best correction. Guttman, Cheryl // Ophthalmology Times;05/01/98, Vol. 23 Issue 9, p32 

    Focuses on the presentation by Kerry Assil at the Hawaii 1998 conference on refractive surgery held in Maui, Hawaii. Changes in the refractive surgery for myopia; Factors underlying the development of techniques; Nomogram for myopia correction based on patient age and refractive error.

  • Intraocular Lens Power Calculation After Corneal Refractive Surgery. Feiz, Vahid // Middle East African Journal of Ophthalmology;Jan2010, Vol. 17 Issue 1, p63 

    Cataract surgery after corneal refractive surgery can be challenging for the ocular surgeon due to the difficulty with accurate intraocular lens (IOL) power determination and unexpected refractive surprises. As clinicians have done more work, a number of error sources have been determined....

  • Custom ablation provides good night vision with larger pupils. Charters, Lynda // Ophthalmology Times;10/1/2004, Vol. 29 Issue 19, p64 

    Reports that custom ablation provides good night vision with larger pupils. Refractive error and increase spherical aberration following conventional refractive surgery.


Read the Article


Sign out of this library

Other Topics