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John Mason, John Mason, Gerald McGwin, Lauren Mason, Thomas Finley, Duncan Friedman, Dustin Pomerleau, Michael Albert, Richard Feist, Martin Thomley; Vitreoretinal Surgical Outcomes Performed by Supervised Retinal Fellows Versus Attending Faculty Surgeons. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3303.
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To evaluate the outcomes of common vitreoretinal surgeries performed by retinal fellows under direct faculty supervision, compared to experienced faculty members.
Retrospective cohort study analyzing 592 eyes undergoing retinal surgery from October 2009 to December 2011 at Retina Consultants of Alabama/University of Alabama at Birmingham Eye Foundation Hospital. Vitreoretinal surgeries included macular hole, macular pucker, retinal detachment, diabetic vitreous hemorrhage, and diabetic tractional retinal detachment. Three fellows performed 390 cases (divided into their 6, 12, and 18-month training), while four faculty performed 202 cases. All 390 fellow performed cases were under the direct supervision and teaching of one of the four faculty members. Chi-square analysis was used to compare outcomes between physicians. Outcome measures were visual improvement, complications, and reoperations.
The mean postoperative visual improvement was significant and equal in all groups, as well as between each physician (p=<0.0001). Complications occurred in 29/592 cases (4.8%), while re-operations occurred in 30/592 cases (5.0%) and were equally distributed across all groups as well as each individual physician (p=0.1002 and p=0.1311 respectively).
With proper training and supervision, retinal fellows can achieve an equally high visual improvement with a low complication and reoperation rate compared to experienced faculty in an academic hospital. The year of fellowship does not significantly influence visual outcomes or complications. Quality visual outcomes after vitreoretinal surgery can be obtained throughout fellowship training.
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