Outcome of Penetrating Keratoplasty Performed by Cornea Fellows Compared With That of an Experienced Staff Surgeon
Bibliographic record
Abstract
PURPOSE: To compare the outcome of penetrating keratoplasty performed by supervised cornea fellows and an experienced staff surgeon. METHODS: Retrospective review of cases of penetrating keratoplasty performed over a 4-year period with corneal topography performed on a clear graft. Overall, 202 cases from 184 patients were included: 108 performed by an experienced staff surgeon and 94 cases by 9 cornea fellows. Charts were reviewed for topographic astigmatism, other topographic indices, refractive astigmatism and best-corrected visual acuity (BCVA), all recorded after removal of the 10-0 sutures while the 11-0 suture remained in place. Graft clarity was assessed at final follow-up. RESULTS: Mean postoperative topographic astigmatism was 4.60 +/- 2.7 diopters in the fellow group and 4.08 +/- 2.41 diopters in the staff group. The mean postoperative time at which corneal topography was obtained was 9.53 +/- 4.4 months in the fellow group and 9.22 +/- 4.6 months in the staff group. Mean refractive astigmatism was 3.77 +/- 1.97 diopters (fellows) and 3.49 +/- 1.93 diopters (staff). Mean surface asymmetry index (SAI) was 1.89 +/- 1.42 (fellows) and 1.61 +/- 1.08 (staff). Mean surface regularity index (SRI) was 1.43 +/- 0.72 (fellows) and 1.45 +/- 0.61 (staff). Mean BCVA was 0.49 logMAR (20/61) +/- 4.3 lines (fellows) and 0.47 logMAR (20/59) +/- 3.9 lines (staff). In the fellow group, 85 (90%) cases remained clear over a mean follow-up of 32 months and in the staff group 100 (93%) grafts remained clear over a mean follow-up of 38 months. Simple and multiple regression analyses indicated no difference between the 2 groups in all outcome measures. CONCLUSIONS: Properly supervised cornea fellows in training achieved favorable penetrating keratoplasty results that were comparable to those of an experienced staff surgeon.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".