The Learning Curve of Pars Plana Vitrectomy.

Lee, Sung Jin; Park, Su Eun

Original Article

Journal of the Korean Ophthalmological Society 2007;48(7):925-934.
Published online July 31, 2007.

The Learning Curve of Pars Plana Vitrectomy.

Sung Jin Lee, Su Eun Park

Department of Ophthalmology, College of Medicine, Soonchunhyang University, Seoul, Korea. wismile@unitel.co.kr

유리체절제술의 학습곡선

이성진,박수은

Department of Ophthalmology, College of Medicine, Soonchunhyang University, Seoul, Korea

Correspondence: 이성진

Abstract

PURPOSE
To determine the learning curve of surgeons who perform vitrectomy by studying the results of the first 500 vitrectomy cases that were performed after a fellowship training course for a retina surgeon. METHODS: The medical records of the first 500 vitrectomy cases performed by a retina surgeon from February 2001 were reviewed. We included the first operation of each eye and excluded partial vitrectomy and ocular laceration cases. We defined failure as reoperation cases within 3 months and cases with serious visual complication. RESULTS: There were 261 eyes (52.2%) from male patients, and 239 eyes (48.7%) from female patients; the average age was 59.7 years old. The causative diseases were, in order of frequency, proliferative diabetic retinopathy, retinal detachment, and branch retinal vein occlusion. The final visual outcomes showed improvement of more than 2 lines in 274 eyes (54.8%), and a decrease of more than 2 lines in 50 eyes (10.0%). Failure was the outcome in 37 eyes (7.4%) and was more frequent in the first 2 years of surgeries; the causes of failure were, in order of frequency, retinal detachment, vitreous hemorrhage, and neovascular glaucoma. Visual acuity in the first 2 years, during which failure was more frequent, was not different from that in the last 3 years. CONCLUSIONS: To achieve consistently stable results in vitrectomy, a newly trained retina surgeon needs about 150 cases of vitrectomy or 2 years of experience.

Key Words: Complication;Failure;Learning curve;Outcome;Vitrectomy