“Comparing outcomes of advanced nurse practitioners to ophthalmologists performing posterior YAG capsulotomy, a six-year study of 6308 eyes”

Purpose To primarily report the baseline characteristics and visual acuity (VA) outcomes of advanced nurse practitioners (ANP) compared to ophthalmologists following YAG posterior capsulotomy (YAGPC). We secondarily looked to characterise the risk factors that lead to a repeated YAGPC. Method Retrospective consecutive case series of 6,308 eyes attending the Birmingham and Midlands Eye Centre. Results ANPs performed 33.1% of YAGPC compared to 66.9% ophthalmologists. Compared to ophthalmologists, ANPs performed YAGPC in lower proportion of patients with ocular co-morbidities ( p < 0.001) and had lower proportion of patients requiring further YAGPC compared to ophthalmologists ( p < 0.001). Median pre, post-operative and LogMAR gain in VA of 0.48 (IQR 0.30–0.78), 0.18 (IQR 0.10–0.40) and 0.30 (0.08–0.48) LogMAR units, respectively. Multivariate regression showed that ANPs had a significantly lower rate of repeat YAGPC compared to ophthalmologists even when adjusting for age, ethnicity, training grade and ocular co-morbidities. No difference in visual outcomes was found between operator grade and ethnicity on multivariate analysis. Conclusion YAGPC leads to excellent visual outcomes. ANPs can deliver safe and effective YAGPC.