Department of Ophthalmology, Louisiana State University at New Orleans, New Orleans, LA; and.
Department of Ophthalmology, University of Texas Health at San Antonio, San Antonio, TX.
Cornea. 2022 Jan 1;41(1):12-15. doi: 10.1097/ICO.0000000000002721.
To compare the recurrence rates after pterygium surgery performed by supervised trainee residents and attending physicians.
This retrospective study included pterygium surgeries performed by trainee residents and attending physicians in an academic institution in South Texas in the years 2008 to 2019. All residents performed surgeries under direct supervision of an attending physician. Only primary pterygium cases with a minimum postoperative follow-up of 6 months were included. Patients' demographics, primary surgeon, use of conjunctival autograft (CAU) or amniotic membrane graft (AMG), recurrence of pterygium, follow-up length, and complications were recorded.
This study included 240 eyes of 229 patients with a mean age of 55.6 ± 12.3 years (range, 28-91 years). Of these eyes, 100 surgeries were performed by attending physicians (including 87 with CAU and 13 with AMG) and 140 surgeries by trainee residents (including 119 with CAU and 21 with AMG). There were no significant differences between the 2 groups of patients regarding age, sex, and surgical technique (CAU vs. AMG). Patients were followed up for an average of 19.8 ± 15.2 months. No statistically significant differences were found in comparing the rate of pterygium recurrence between attending physicians and residents when using CAU (6.8% vs. 10.0%, respectively; P = 0.42) and AMG (69.2% vs. 47.6%, respectively; P = 0.22). Moreover, there were no significant differences in other postoperative complications between the groups.
Pterygium recurrence rates were similar between attending physicians and supervised trainee residents. Thus, acceptable outcomes can be expected when pterygium surgery is performed by a supervised ophthalmology resident.
比较在有监督的住院医师和主治医生进行的翼状胬肉手术后的复发率。
这是一项回顾性研究，纳入了 2008 年至 2019 年在德克萨斯州南部一家学术机构由住院医师和主治医生进行的翼状胬肉手术。所有住院医师均在主治医生的直接监督下进行手术。仅纳入原发性翼状胬肉病例，且术后随访时间至少为 6 个月。记录患者的人口统计学特征、主刀医生、是否使用结膜自体移植物（CAU）或羊膜移植（AMG）、翼状胬肉复发、随访时间和并发症。
本研究纳入了 229 例 240 只眼患者，平均年龄为 55.6±12.3 岁（范围：28-91 岁）。这些患者中，有 100 只眼的手术由主治医生完成（其中 87 例使用 CAU，13 例使用 AMG），140 只眼的手术由住院医师完成（其中 119 例使用 CAU，21 例使用 AMG）。两组患者在年龄、性别和手术技术（CAU 与 AMG）方面无显著差异。患者平均随访 19.8±15.2 个月。当使用 CAU 时，主治医生和住院医师的翼状胬肉复发率分别为 6.8%和 10.0%（P=0.42），当使用 AMG 时，复发率分别为 69.2%和 47.6%（P=0.22），两组间差异均无统计学意义。此外，两组间其他术后并发症无显著差异。
在有监督的住院医师和主治医生进行的翼状胬肉手术中，复发率相似。因此，在有监督的眼科住院医师进行翼状胬肉手术时，可以获得可接受的结果。
