September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Surgical outcomes of small gauge pars plana vitrectomy for repair of primary rhegmatogenous retinal detachment performed by vitreoretinal fellows under attending supervision
Author Affiliations & Notes
  • Jay Wang
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Rashi Joshi
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
  • Anne Marie Lane
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Demetrios Vavvas
    Ophthalmology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
    Ophthalmology, Harvard Medical School, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Jay Wang, None; Rashi Joshi, None; Anne Marie Lane, None; Demetrios Vavvas, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 1034. doi:
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    • Get Citation

      Jay Wang, Rashi Joshi, Anne Marie Lane, Demetrios Vavvas; Surgical outcomes of small gauge pars plana vitrectomy for repair of primary rhegmatogenous retinal detachment performed by vitreoretinal fellows under attending supervision. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1034.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Clinical outcomes of surgeries performed by vitreoretinal fellows under attending supervision have not been extensively studied and are not routinely tracked by surgical fellowship programs. We performed a retrospective clinical study to investigate visual and anatomical outcomes of small gauge pars plana vitrectomy (PPV) for repair of primary rhegmatogenous retinal detachment (RRD) performed by vitreoretinal fellows under attending supervision at an academic tertiary care setting.

Methods : This study was approved by the Institutional Review Board at the Massachusetts Eye and Ear Infirmary (MEEI). Patients who underwent small gauge PPV for primary RRD from January 2007 to December 2012 by 19 vitreoretinal fellows under supervision of the same attending surgeon at the MEEI with at least 3 months follow up were included. Exclusion criteria included history of trauma, previous vitreoretinal surgery in the involved eye, chronic retinal detachment, tractional or exudative retinal detachment. A stepwise logistic regression model was used to identify predictors of surgical failure.

Results : 125 eyes of 117 patients were included in the study with a mean age of 57.8 ± 12.7 years. 67.5% of patients were male. 58.4% of eyes had suffered a macula-off detachment. After a median follow up time of 29 months, the primary anatomical success rate was 88.8% and the final anatomical success rate was 97.6%. The mean logMAR best corrected visual acuities improved from 1.06 ± 1.02 preoperatively to 0.37 ± 0.48 postoperatively (p < 0.001). Common postoperative complications included cataract progression (50%), epiretinal membranes (45.6%), transient elevated intraocular pressure > 30 mmHg (20.8%), and cystoid macular edema (13.6%). Predictors of surgical failure included duration of symptoms (p = 0.09) and failure of initial pneumatic cryopexy at 2 weeks or more (p = 0.002).

Conclusions : Clinical outcomes of small gauge pars plana vitrectomy for repair of primary rhegmatogenous retinal detachment performed by vitreoretinal fellows under attending supervision at an academic teaching hospital are similar to the nationwide reported average by practicing physicians. Tracking the outcomes of surgeries performed by fellows under attending supervision within surgical training programs should be considered to ensure quality of patient care.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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