Justin Grant A, Purt Boonkit, Abousy Mya, Qiu Mary, Fekrat Sharon, Woreta Fasika A, Vajzovic Lejla
Department of Vitreoretinal Surgery, Duke Eye Center, Durham, North Carolina.
Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
J Acad Ophthalmol (2017). 2023 Apr 24;15(1):e99-e105. doi: 10.1055/s-0043-1768022. eCollection 2023 Jan.
To analyze resident vitreoretinal procedure volume across Accreditation Council of Graduate Medical Education (ACGME) accredited ophthalmology residency programs. We assessed the effect of the increase in intravitreal injections (IVI), geographic region, program size, and Veterans Affairs (VA) and vitreoretinal fellowship affiliation on vitreoretinal procedures. A request was sent to all residency programs in 2018 for their graduating residents' ACGME case logs. Vitreoretinal procedures were defined by ACGME case log categories and included vitreoretinal surgery, peripheral retinal lasers, and IVI. Procedures were categorized by Current Procedural Terminology (CPT) code. Programs were studied by geographic region, program size, and by VA and vitreoretinal fellowship affiliation. A total of 38 of 115 (33.0%) programs responded, and 167 residents logged 32,860 vitreoretinal procedures. The median number of retina procedures per resident was 146 (range 36-729). Programs with a vitreoretinal fellowship had a higher average number of vitreoretinal procedures per resident (208.3 vs. 125.0; = 0.002), but there was no difference between the average number of non-IVI vitreoretinal procedures (60.0 vs. 64.2; = 0.32). For IVI, VA affiliation (146.6 vs. 71.1; = 0.02) and vitreoretinal fellowship (149.4 vs. 60.8; < 0.001) were associated with a greater number. More IVI strongly correlated with a larger total volume of retinal procedures ( = 0.98), and there was no difference across programs for total retinal procedures when IVI was removed. The presence of a vitreoretinal fellowship at a residency program had a positive effect on resident total vitreoretinal case volume, but their residents performed more IVI. Programs without vitreoretinal fellowships completed on average more non-IVI procedures.
分析美国研究生医学教育认证委员会（ACGME）认证的眼科住院医师培训项目中住院医师的玻璃体视网膜手术量。我们评估了玻璃体内注射（IVI）增加、地理区域、项目规模、退伍军人事务部（VA）以及玻璃体视网膜专科 fellowship 附属关系对玻璃体视网膜手术的影响。
2018 年向所有住院医师培训项目发送了请求，索要其毕业住院医师的 ACGME 病例记录。玻璃体视网膜手术由 ACGME 病例记录类别定义，包括玻璃体视网膜手术、周边视网膜激光治疗和 IVI。手术按现行手术操作术语（CPT）代码分类。按地理区域、项目规模以及 VA 和玻璃体视网膜专科 fellowship 附属关系对项目进行研究。
115 个项目中有 38 个（33.0%）做出回应，167 名住院医师记录了 32,860 例玻璃体视网膜手术。每位住院医师视网膜手术的中位数为 146 例（范围 36 - 729 例）。有玻璃体视网膜专科 fellowship 的项目中每位住院医师的玻璃体视网膜手术平均数量更高（208.3 例对 125.0 例；P = 0.002），但非 IVI 玻璃体视网膜手术的平均数量之间没有差异（60.0 例对 64.2 例；P = 0.32）。对于 IVI，VA 附属关系（146.6 例对 71.1 例；P = 0.02）和玻璃体视网膜专科 fellowship（149.4 例对 60.8 例；P < 0.001）与更多数量相关。更多的 IVI 与视网膜手术总量更大密切相关（r = 0.98），去除 IVI 后各项目视网膜手术总量没有差异。
住院医师培训项目中存在玻璃体视网膜专科 fellowship 对住院医师玻璃体视网膜病例总数有积极影响，但他们的住院医师进行了更多的 IVI。没有玻璃体视网膜专科 fellowship 的项目平均完成更多的非 IVI 手术。
