Abstract
Purpose :
To determine the trends of surgical experience in cornea, glaucoma, and retina subspecialty fellowship training from 2009 to 2016.
Methods :
Data from AUPO FCC Fellow Exit Survey Surgical Reports (2009 – 2016) and San Francisco Ophthalmology fellowship match statistics reports (2010-2015) were reviewed. The average number of cases performed by fellows in each subspecialty from 2009 to 2016 were analyzed for trends.
Results :
Fellowship programs and positions increased in all three subspecialities from 2009 to 2015, especially in the field of retina (+30%). In retina fellowship, the average number of cases of posterior vitrectomy increased by 21.8% (442.3 to 538.8). Scleral buckles decreased by 24.9% (88 to 66.1). Laser photocoagulations decreased by 12.1% (335 to 295). In cornea fellowship, penetrating keratoplasties decreased by 15.2% (49.9 to 42.3). Endothelial keratoplasties increased by 18.6% (46.3 to 54.9). Deep anterior lamellar keratoplasties increased by 37% (3 to 4.1). Keratectomies increased by 53% (8.7 to 13.3). Phakic intraocular lens implants increased by 118% (1.1 to 2.4). LASIK procedures decreased by 7.7% (61.3 to 56.6). In glaucoma fellowship, aqueous shunt placements increased by 58.8% (45.9 to 72.9). Anterior chamber to Schlemm’s canal shunts increased from 0 to 17.1. Trabeculectomies and Express shunts decreased by 11.1% (69.1 to 61.4). Trabeculoplasties increased by 40.1% (15.2 to 21.3). Uncomplicated cataract cases increased by 74.6% (66.1 to 115). Complicated cataract cases increased by 17.8% (25.8 to 30.4). Combined cataract and glaucoma procedures increased by 126% (17.1 to 38.7). Endocyclophotocoagulations increased by 53.1% (6.4 to 9.8).
Conclusions :
Fellowships provide important additional surgical training after residency. With recent advances and the development of new techniques in each field, fellowship surgical case surveys in all three areas reflected changing practice patterns and the gradual incorporation of new treatments into training curriculums. For certain surgeries, long-term trends in fellowship training may also reflect the acceptance or rejection of some treatment options.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.