Comparison of Strabismus Surgical Efficiency and Complications Between Attending Surgeon Versus Supervised...

To compare surgical operating times and complication rates in strabismus surgery undertaken by attending surgeons versus supervised residents. Eye muscle surgeries are one of the first operations in which ophthalmology residents can actively participate for a majority of the surgery. These surgeries provide an ideal controlled environment to compare attending surgeon and resident surgical performance.

A total of 36 surgeries were included: 19 were bilateral muscle surgeries and 17 were unilateral surgeries. Residents completed a microsurgical course prior to operating. One attending surgeon was present for all surgeries, but there were 10 different residents throughout the cases. Primary outcomes were attending surgeon and resident surgical times and complications.

On average, residents took 35.5 minutes to perform eye muscle surgeries compared to 19.3 minutes for the attending surgeon (P < .0001). Of the resident surgeries, there was one complication requiring a return to the operating room. There were six minor complications during resident surgeries and one minor complication during attending surgeon surgery.

As expected, resident operation times were nearly double attending surgeon surgical times. Although there was one significant and several minor complications resulting from resident surgeries, none were vision threatening. This microsurgical course likely contributed to the low number of complications. The longer surgical times and minor complications resulting from resident surgeries require physicians to disclose resident involvement during the consenting process for pediatric strabismus surgeries. [J Pediatr Ophthalmol Strabismus. 2020;57(4):235-237.].