Efficiency in skill development of pterygium excision with amniotic membrane transplantation among the 1st year ophthalmology residents at Thammasat Eye Center

Abstract

To evaluate the learning curve of pterygium excision with amniotic membrane transplantation among the 1 st year ophthalmology residents. Methods: Prospective comparative study. Four first year ophthalmology residents were monitored for operating time and recurrence rate on all their cases of pterygium excision with amniotic membrane transplantation throughout one year. Data for baseline characteristic of patients with continuous data were analyzed for differences among residents using one-way ANOVA. Proportional data such as age, gender, laterality and recurrence rate were analyzed for differences among residents using Fisher's exact test. Average predicted operating time with consecutive cases were analyzed using linear regression. Operating time stabilization with consecutive cases was visualized by a Locally Weighted Scatterplot Smoothing (LOWESS) and Quadratic best fit lines. Results: A total of 159 eyes (159 patients) with primary pterygium excision were performed with sutured amniotic membrane transplantation. All cases were attributed to four ophthalmology residents composed of 40, 41, 42 and 36 patients. The average operating time was 50.38 ± 13.92 minutes, with a range of 28 to 100 minutes. The operating time declined in proportion to the number of patients and stabilized after 38 cases (average time 43.33 ± 18.93 minutes). The recurrence rate of pterygium found in this study was 11.94% Conclusions: Pterygium excision with sutured amniotic membrane transplantation is considered as appropriate training procedure for ophthalmology residency training due to less duration needed to reach the learning curve. Additionally, the rate of recurrence among residents is comparable to that of other similar studies.