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KMID : 0360220070480070925
Journal of the Korean Ophthalmological Society
2007 Volume.48 No. 7 p.925 ~ p.934
The Learning Curve of Pars Plana Vitrectomy
Lee Sung-Jin

Park Su-Eun
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.
KEYWORD
Complication, Failure, Learning curve, Outcome, Vitrectomy
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