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The learning curve of retinal detachment surgery
Viola Radeck1, Horst Helbig2, Teresa Barth1
1Department of Ophthalmology, University Hospital of Regensburg, Franz-Josef-Strauss-Allee 11, DE-93042, Regensburg, Germany.
Summary
Vitreoretinal surgeons achieve stable retinal detachment surgery success rates after approximately 200 operations. Early career surgeons show improvement, with outcomes stabilizing as experience grows.
Area of Science:
- Ophthalmology
- Surgical Training
Background:
- Retinal detachment (RD) surgery is a complex procedure.
- Understanding the learning curve for new vitreoretinal (VR) surgeons is crucial for optimizing training and patient outcomes.
Purpose of the Study:
- To investigate the learning curve of vitreoretinal (VR) surgeons during their initial training in retinal detachment (RD) surgery.
- To determine the number of cases required to achieve proficiency in RD surgery.
Main Methods:
- Retrospective review of consecutive patients undergoing VR surgery for uncomplicated RD between January 2005 and March 2020.
- Analysis of primary success rates and operative times based on surgeon experience, defining success as no redetachment within 3 months.
Main Results:
- Ten VR surgeons performed 3786 RD operations. Initial success rates for novice surgeons were around 80%, improving to 90% overall.
- Redetachment rates decreased and stabilized below 10% after approximately 200 operations.
- Beginner surgeons took over twice as long as experienced surgeons; individual learning curves varied, with female surgeons showing a potentially faster progression.
Conclusions:
- Retinal detachment surgery by VR surgeons in training yields acceptable results.
- Surgical success rates improve with experience, stabilizing around 200 operations.
- Training VR surgeons requires significant resources and time to reach proficiency.
