Mason John O, Mason Lauren B, Patel Shyam A, McGwin Gerald, Finley Thomas A, Friedman Duncan A, Pomerleau Dustin L, Albert Michael A, Feist Richard M, Thomley Martin L, Mason John O
*Retina Consultants of Alabama, Callahan Eye Foundation Hospital, Birmingham, Alabama; and †Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, Alabama.
Retina. 2016 May;36(5):981-5. doi: 10.1097/IAE.0000000000000828.
To evaluate common vitreoretinal surgeries performed by retinal fellows under direct faculty supervision, compared with experienced faculty members.
Retrospective study analyzing 592 consecutive eyes undergoing retinal surgery from 2009 to 2011 at Retina Consultants of Alabama/University of Alabama at Birmingham, Department of Ophthalmology. Vitreoretinal surgeries included macular hole, macular pucker, retinal detachment, diabetic vitreous hemorrhage, and diabetic tractional retinal detachment. Three fellows performed 390 cases (divided into first or second year fellows), while 4 faculty members performed 202 cases. All 390 fellow-performed cases were under direct supervision. Chi-square analysis was used to compare outcomes.
There were no baseline differences between the groups. The mean postoperative visual improvement was statistically significant and equal in all groups, as well as between each physician (P ≤ 0.0001). Complications occurred in 29/592 cases (4.8%), whereas reoperations occurred in 21/592 cases (3.5%) and were equally distributed across groups. There were no differences in complications and reoperations when comparing first-year with second-year fellows.
With proper supervision, vitreoretinal fellows can achieve an equally high visual improvement with low complication and reoperation rates compared with experienced faculty. The year of fellowship does not significantly influence outcomes or complications. Quality outcomes after vitreoretinal surgery can be obtained throughout fellowship training.
评估在教员直接监督下视网膜专科住院医师进行的常见玻璃体视网膜手术，并与经验丰富的教员进行比较。
回顾性研究分析了2009年至2011年在阿拉巴马视网膜咨询公司/阿拉巴马大学伯明翰分校眼科接受视网膜手术的592例连续病例。玻璃体视网膜手术包括黄斑裂孔、黄斑皱襞、视网膜脱离、糖尿病性玻璃体出血和糖尿病性牵拉性视网膜脱离。三名专科住院医师进行了390例手术（分为第一年或第二年的专科住院医师），而四名教员进行了202例手术。所有390例由专科住院医师进行的手术均在直接监督下进行。采用卡方分析比较结果。
两组之间在基线方面无差异。所有组以及每位医生术后平均视力改善在统计学上均有显著意义且相当（P≤0.0001）。592例中有29例（4.8%）发生并发症，21例（3.5%）需要再次手术，且在各小组中分布均匀。比较第一年和第二年的专科住院医师，并发症和再次手术情况无差异。
在适当监督下，与经验丰富的教员相比，玻璃体视网膜专科住院医师能够实现同样高的视力改善，且并发症和再次手术率较低。专科住院医师培训的年份对结果或并发症没有显著影响。在整个专科住院医师培训期间都可以获得玻璃体视网膜手术后的良好质量结果。
