The learning curve of retinal detachment surgery

Radeck, Viola; Helbig, Horst; Barth, Teresa; Gamulescu, Maria-Andreea; Maerker, David; Prahs, Philipp

doi:10.1007/s00417-021-05096-1

Cited by 13 publications

(16 citation statements)

References 18 publications

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“…The primary surgical success rate was 60%, which was much lower than the general anatomical success rate reported in other studies ( 16 – 19 ). However, the small sample size ( n = 30 eyes) in our study should be noted.…”

Section: Discussioncontrasting

confidence: 65%

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Outcomes and eye care knowledge in rhegmatogenous retinal detachment patients with a history of laser refractive surgery for myopia

Lan

Chen

et al. 2022

Front. Public Health

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PurposeTo investigate the surgical outcomes and eye care knowledge of patients with rhegmatogenous retinal detachment (RRD) who had previously undergone laser refractive surgery (LRS) for myopia in a myopia epidemic area.MethodsThis retrospective study included patients with primary RRD who underwent surgery and had a history of LRS for myopia at a tertiary medical center. Data were reviewed from medical charts to analyse the surgical outcomes. Questions about eye care knowledge and attitude toward myopia and LRS were obtained.ResultsA total of 774 patients underwent RRD surgery, among whom 341 (44%) had myopia > −3 dioptres, 66% of whom had high myopia. Thirty eyes of 26 patients had a history of LRS for myopia. The mean age of patients with a history of LRS was significantly lower than that of those without a history of LRS (45.7 ± 2.9 years vs. 53.8 ± 1.0, p < 0.001). The mean pre-LRS spherical equivalent was −8.66 ± 0.92 (range: −3.00–−12.00) dioptres. In more than half the patients (n = 15, 57.7%), the interval between LRS and RRD was more than 10 years. The primary retinal reattachment rate was only 60%, whereas the final retinal reattachment rate was 93%. The mean final visual acuity (VA) improved from a 20/286 to 20/105 (p = 0.006). Linear mixed model analysis showed factors of male sex and macular detachment were significant with poor visual outcome (p = 0.046 and 0.008) Eye care knowledge obtained from the 19 RRD patients with history of LRS, 47% of patients (9/19) mistakenly thought that LRS could cure myopia and its complications, and 63% of patients were less willing to visit an ophthalmologist because uncorrected VA improvement after LRS. Eighty-four percent thought that proper knowledge and more education about LRS and myopia for the public are important.ConclusionIn the RRD patients with a history of LRS for myopia, their age was relative younger. Male sex and macular detachment were associated with poor visual outcome. More education with proper knowledge of LRS, myopia and RRD is recommended for the patients to prevent or early detect the occurrence of RRD.

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Section: Discussioncontrasting

confidence: 65%

“…A Japanese study showed the primary surgical success rate within 6 months was 90.8(2,519/2,775) ( 18 ). A German study showed the primary success rate after one operation was 90% (3,420/3,786) ( 19 ). An UK study showed the primary success rate with a single procedure was 86.8% (302/348) ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

Outcomes and eye care knowledge in rhegmatogenous retinal detachment patients with a history of laser refractive surgery for myopia

Lan

Chen

et al. 2022

Front. Public Health

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“…In previous retrospective reviews of rhegmatogenous retinal detachment (RRD) surgeries performed by beginner surgeons, the primary success rates were 70% [ 14 ], 75% [ 23 ], and 80% [ 13 ], and they improved and then stabilized after about 200 operations [ 13 ] or 2 years [ 14 ]. In another study, the learning effect was reduced by half after about 500 vitreoretinal surgeries [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…While several approaches have been used to study the learning curve of phacoemulsification [ 8 , 9 , 10 ] and refractive surgery [ 11 , 12 ], few authors have studied the learning curve of PPV, usually for rhegmatogenous retinal detachment surgery [ 13 , 14 , 15 , 16 ], and even fewer have assessed the progress in gaining experience and skills of young surgeons attempting TRD surgery [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

The Learning Curve of Surgery of Diabetic Tractional Retinal Detachment—A Retrospective, Comparative Study

et al. 2022

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Background and Objectives: There are few data in the literature concerning the learning curve of tractional retinal detachment (TRD) surgery. We have analyzed the experience gained by a vitreoretinal surgeon over 10 years. Materials and Methods: A retrospective, comparative study of 34 TRD cases operated using 20G instruments between 2008 and 2011 (group A) and 94 cases operated using 23G instruments between 2015 and 2019 (group B). The preoperative characteristics, the type of endotamponade, and the anatomical and functional success were reviewed. Results: The group A patients had a significantly higher rate of concomitant vitreous hemorrhage (VH) at presentation (64.7% vs. 37.2%) and of non-macular retinal detachments (52.9% vs. 39.3%). The rate of silicone oil endotamponade was high in both groups (76.4% vs. 68.1%), but in group B 25.5% were left without a tamponade (vs. none in group A). A postoperative anatomical success was obtained in 76.5% of eyes in group A and 84.04% of eyes in group B (where it was improved to 89.3% by reinterventions). The presenting visual acuity (VA) was very low in both groups (0.01 and 0.05, respectively). The proportion of eyes with improved or stabilized VA was 85.3% in group A and 79.8% in group B (statistically non-significant difference). Conclusions: The anatomical success rate improves quite slowly with increasing surgeon experience and can be further improved by reinterventions. Visual improvement does not match the rate of anatomical improvement. With increasing experience and self-confidence, the surgeon will approach more difficult cases, a fact that may slow down the increase in surgical success rates.

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“…In fact, female vitreoretinal surgeons have been shown to have a faster learning curve than their male peers in training for retinal detachment surgery. 13 Thus, while this work focused on the representation of women in retina society membership, leadership, and achievement, we also want to acknowledge the many potential benefits of an increasing proportion of women in the specialty at large.…”

Section: Introductionmentioning

confidence: 99%

Trends in Leadership and Award Recognition Among Women in the American Society of Retina Specialists

Reeves

Pasricha

Ludwig

et al. 2021

Journal of VitreoRetinal Diseases

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Purpose: This work evaluates trends in achievement of women in the retina field, through an analysis of gender representation in the American Society of Retina Specialists (ASRS). Methods: This retrospective, longitudinal study spans 1983 to 2020. Historical data classified by male or female gender were collected from ASRS's overall membership, board of directors and officers, and recipients of the 4 society awards. The proportion of each benchmark held by women was compared with prior decades since the founding of ASRS using the Fisher’s exact test. Results: Women’s representation increased from 11% of ASRS members in 2007 to 19.7% in 2020. From 2010 to 2019, women received a higher proportion of society awards (21.1%) compared with membership prior to the start of that decade. In 2020, women were proportionally well represented in board of director positions (21.9%) and held a significantly higher proportion of board positions than in the period 1983 to 1989 ( P = .02). From 1983 to 2020, women held 4.3% (1 of 23) of presidencies. Conclusions: Although the number of women in retina is increasing, women remain underrepresented in the leadership of ASRS. Interventions to increase exposure to female mentorship and improve childcare benefits are warranted to engage female ophthalmology trainees in retina and ultimately society leadership.

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The learning curve of retinal detachment surgery

Cited by 13 publications

References 18 publications

Outcomes and eye care knowledge in rhegmatogenous retinal detachment patients with a history of laser refractive surgery for myopia

Outcomes and eye care knowledge in rhegmatogenous retinal detachment patients with a history of laser refractive surgery for myopia

The Learning Curve of Surgery of Diabetic Tractional Retinal Detachment—A Retrospective, Comparative Study

Trends in Leadership and Award Recognition Among Women in the American Society of Retina Specialists

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