Woo Hyok Chang, (Daegu, South Korea)

PURPOSE:

To provide an insight into the learning curve of ophthalmologist in fellowship course associated with scleral buckling procedure and to determine risk factors affecting outcomes during this period.

METHODS:

Prospective data were collected on 80 consecutive scleral buckling operations alone performed by author over a 22-month period, beginning with his first year fellowship course. All patients were having the first surgical procedure for rhegmatogenous retinal detachment and they were divided in four groups of 20 consecutive cases. The primary outcome measure was anatomical reattachment of the retina with a single intervention.

RESULTS:

There was no significant difference among the groups in terms of mean age, duration of macular detachment, number of retinal breaks, size of retinal break, or location of retinal break. Single-operation anatomic success rate was 75% (15/20) in the first group, 80% (16/20) in second, 85% (17/20) in third and 85% (17/20) in the last group, respectively. Overall success rate was 81.3% with a single procedure. Number of breaks (multiple rather than single, p=0.001) and type of break (tear rather than hole, p=0.005) were proved to be risk factors for failure during this period. The average duration of follow-up was 15 months.

CONCLUSION:

Through the experience of beginning retinal surgeon, this study has shown smooth learning curve with acceptable overall success rates of buckling operation, and careful case selection avoiding high risk group may increase success rate during this period.