{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:28:46Z","timestamp":1760059726886,"version":"build-2065373602"},"reference-count":31,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T00:00:00Z","timestamp":1751500800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vision"],"abstract":"<jats:p>Evidence based practice enhances healthcare delivery and prevents unsafe procedures. While competency based assessments of resident cataract surgery are standard, evidence based analysis of refractive outcomes remains underutilized in educational curricula. This retrospective single center study evaluated refractive outcomes from 21 novice ophthalmology resident surgeons. Three independent groups were compared based on formal constant optimization for intraocular lens (IOL) calculation: non-optimized Haigis (n = 216), a0-optimized (n = 94), and a0\/a1\/a2-optimized (n = 121). All surgeries were supervised by a single attending surgeon. Mean absolute error (MAE) and the percentage of eyes within \u00b10.25 D and \u00b10.50 D of predicted spherical equivalent (SEQ) were calculated. Also, systematic bias in effective lens position (ELP) was analyzed to update manufacturer IOL constants. MAE improved from 0.44 D (non-optimized) to 0.35 D (a0-optimized p = 0.009) and 0.19 D (a0\/a1\/a2-optimized p &lt; 0.001). The percentage within \u00b10.50 D increased from 65.7% to 74.4% to 95.0%, respectively. With ELP bias correction, updated A constant and ACD were 119.266 and 5.755 mm. a0\/a1\/a2-optimized outcomes were comparable to ELP bias correction for the Barrett UII, Kane, and Hill-RBF formulas. Evidence based optimization of IOL constants significantly enhances novice resident surgical outcomes, achieving parity with prediction models. A formal curriculum on IOL calculation and optimization is warranted.<\/jats:p>","DOI":"10.3390\/vision9030052","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T06:01:33Z","timestamp":1751522493000},"page":"52","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evidence Based Analysis Enhances Surgical Outcomes of Novice Resident Surgeons"],"prefix":"10.3390","volume":"9","author":[{"given":"Neel K.","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, School of Medicine, The University of North Carolina at Chapel Hill, 5151 Bioinformatics Bldg., CB# 7040, Chapel Hill, NC 27599, USA"},{"name":"The Kittner Eye Center, 2226 Nelson Highway, Suite 200, Chapel Hill, NC 27517, USA"},{"name":"School of Osteopathic Medicine, Campbell University, P.O. Box 4280, Buies Creek, NC 27506, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth L.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, School of Medicine, The University of North Carolina at Chapel Hill, 5151 Bioinformatics Bldg., CB# 7040, Chapel Hill, NC 27599, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1016\/j.ophtha.2004.04.004","article-title":"The impact of the new competencies on resident education in ophthalmology","volume":"111","author":"Lee","year":"2004","journal-title":"Ophthalmology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.survophthal.2009.04.004","article-title":"The ACGME outcome project in ophthalmology: Practical recommendations for overcoming the barriers to local implementation of the national mandate","volume":"54","author":"Lee","year":"2009","journal-title":"Surv. 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