Background
The number of females in ophthalmology has steadily increased over recent decades. The aim of this study was to evaluate whether there is a difference in procedural volume and cataract surgery between male and female trainees in the Royal Australian and New Zealand College of Ophthalmologists (RANZCO).
Methods
A longitudinal retrospective review of de‐identified surgical RANZCO trainee logbook data from 2008 to 2020 was undertaken. Data from 241 trainee logbooks were analysed for: location of training, gender, date of commencement of training, maternity/paternity leave status, number of surgeries observed, assisted, supervised and unsupervised. Surgical cases were grouped as: (1) all surgical cases; (2) complete cataract cases and (3) partial cataract cases.
Results
Among 241 trainees (40.7% females), 197 263 procedures were performed. Total surgical volume was 21.1% lower at 4 years for females (median 665.5 vs. 843.5; p = 0.036). Completed cataract surgery was 21.5% lower at 18 months (median 87.5 vs. 111.5; p = 0.022) and 41.7% lower at 4 years (median 216 vs. 369; p < 0.001). Interrupted training was significantly more common in females (30.6% vs. 0.7%; p < 0.001). However, linear regression analysis did not identify parental leave or duration as a significant predictor for number of completed cataracts (p = 0.206). Complication rate was not different between males and females (p = 0.35).
Conclusions
Female trainees completed 41.7% fewer cataract operations at the end of their training compared to male counterparts with the gap widening between years 1 and 4 of training. The current data demonstrates that female and male RANZCO trainees are not receiving equivalent operating experiences.
A 51-year-old man presented with a history of cloudy vision in the left eye with minimal discomfort. On slitlamp examination, he had 4 well-healed radial keratotomy (RK) incisions in each eye. Severe corneal edema was observed in the inferotemporal aspect of the left eye, consistent with acute hydrops. The patient was managed conservatively with observation and frequent topical lubrication for comfort. The clinical signs of corneal edema resolved over a period of several months, with worsened resultant scarring around the 5-o'clock keratotomy incision. Corneal ectasia is an established late complication of RK. Of interest in this case, the area of corneal hydrops was well demarcated because the RK scars formed a barrier against further progression of corneal edema.
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