The Impact of Trainee Involvement on Outcomes in Strabismus Surgery

Area of Science:

• Ophthalmology
• Surgical Education
• Pediatric Surgery

Background:

• Strabismus surgery outcomes are critical for visual development.
• Evaluating the impact of surgical trainee involvement is essential for residency training and patient safety.

Purpose of the Study:

• To compare surgical outcomes between strabismus procedures performed solely by attending surgeons and those involving surgical trainees.
• To assess the safety and efficacy of trainee participation in ophthalmic surgeries.

Main Methods:

• Retrospective review of 215 strabismus surgeries (110 esotropia, 105 exotropia).
• Procedures included bilateral medial rectus recessions (BMR) and bilateral lateral rectus recessions (BLR).
• Outcomes analyzed included success rate (alignment <10 prism diopters at 2 months), reoperation rates, complications, and medication use.

Main Results:

• Success rates were 83% for attending-only and 80.5% for trainee-involved cases (P = .65).
• Reoperation rates were lower in trainee-involved cases (22%) compared to attending-only cases (34%) (P = .046).
• Intraoperative complication rates were similar between groups (1 vs 1, P = .729).

Conclusions:

• Trainee involvement in strabismus surgery, with appropriate supervision, is as safe and effective as procedures performed by attending surgeons alone.
• The study supports increased trainee participation in ophthalmic surgeries.
• Lower reoperation rates in trainee cases may indicate selection of less complex cases for trainees.