Download PDF
CC BY-NC-ND 4.0 · Journal of Academic Ophthalmology 2023; 15(01): e99-e105
DOI: 10.1055/s-0043-1768022
Research Article

Resident Vitreoretinal Procedure Volume: Effect of Intravitreal Injections, Region, Program Size, and Vitreoretinal Fellowship and Veterans Affairs Affiliation

Grant A. Justin 
1   Department of Vitreoretinal Surgery, Duke Eye Center, Durham, North Carolina
2   Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland
,
Boonkit Purt
2   Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland
3   Department of Ophthalmology, Walter Reed National Military Medical Center, Bethesda, Maryland
,
Mya Abousy
4   Division of Cornea, Cataract and External Diseases, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
,
Mary Qiu
4   Division of Cornea, Cataract and External Diseases, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
,
Sharon Fekrat
1   Department of Vitreoretinal Surgery, Duke Eye Center, Durham, North Carolina
,
Fasika A. Woreta
4   Division of Cornea, Cataract and External Diseases, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
,
Lejla Vajzovic
1   Department of Vitreoretinal Surgery, Duke Eye Center, Durham, North Carolina
› Author Affiliations Funding None.
› Further Information
   Permissions and Reprints

Abstract

Purpose 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.

Methods 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.

Results 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; p = 0.002), but there was no difference between the average number of non-IVI vitreoretinal procedures (60.0 vs. 64.2; p = 0.32). For IVI, VA affiliation (146.6 vs. 71.1; p = 0.02) and vitreoretinal fellowship (149.4 vs. 60.8; p < 0.001) were associated with a greater number. More IVI strongly correlated with a larger total volume of retinal procedures (r = 0.98), and there was no difference across programs for total retinal procedures when IVI was removed.

Conclusions 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.

Keywords

resident education - ACGME - vitreoretinal surgery - intravitreal injection

Informed Consent

No informed consent was required for the publication of this manuscript.


Note

Abstract was presented at the Retina Society Annual Meeting, September 2021, Chicago, Illinois.


Disclaimer

The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Air Force, the Department of the Army, Department of Defense, the Uniformed Services University of the Health Sciences, or any other agency of the U.S. Government.




Publication History

Received: 10 February 2022

Accepted: 01 March 2023

Article published online:
24 April 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA