Korean J Ophthalmol.  2018 Feb;32(1):59-64. 10.3341/kjo.2017.0059.

Effects of Surgical Assistant's Level of Resident Training on Surgical Treatment of Intermittent Exotropia: Operation Time and Surgical Outcomes

• Kim MH
• Chung H
• Kim WJ
• Kim MM

• KMID: 2402721
• DOI: http://doi.org/10.3341/kjo.2017.0059

Abstract

PURPOSE
To evaluate the effects of the surgical assistant's level of resident training on operation time and surgical outcome in the surgical treatment of intermittent exotropia.
METHODS
This study included 456 patients with intermittent exotropia who underwent lateral rectus recession and medial rectus resection and were followed up for 24 months after surgery. The patients were divided into two groups according to the surgical assistant's level of resident training: group F (surgery assisted by a first-year resident [n = 198]) and group S (surgery assisted by a second-, third-, or fourth-year resident [n = 258]). The operation time and surgical outcomes (postoperative exodeviation and the number of patients who underwent a second operation) were compared between the two groups.
RESULTS
The average operation times in groups F and S were 36.54 ± 7.4 and 37.34 ± 9.94 minutes, respectively (p = 0.33). Immediate postoperative exodeviation was higher in group F (0.79 ± 3.82 prism diopters) than in group S (0.38 ± 3.75 prism diopters). However, repeated-measures analysis of variance revealed no significant difference in exodeviation between the two groups during the 24-month follow-up period (p = 0.45). A second operation was performed in 29.3% (58 / 198) of the patients in group F, and in 32.2% (83 / 258) of those in group S (p = 0.51).
CONCLUSIONS
No significant difference in operation time was observed when we compared the effects of the level of resident training in the surgical treatment of intermittent exotropia. Although the immediate postoperative exodeviation was higher in patients who had undergone surgery assisted by a first-year resident, the surgical outcome during the 24-month follow-up was not significantly different.

Keyword

Exotropia; Internship and residency; Ophthalmic assistants; Strabismus; Surgical procedures

MeSH Terms

Exotropia*
Follow-Up Studies
Humans
Internship and Residency
Ophthalmic Assistants
Strabismus

Figure

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  Fig. 1 The postoperative angle of deviation over the 24-month follow-up for groups F and S. Group F: patients with intermittent exotropia who underwent surgery assisted by a first-year resident. Group S: patients with intermittent exotropia who underwent surgery assisted by a second-, third- or fourth-year resident. Repeated measures analysis of variance revealed no significant difference in exodeviation over 24 months postoperatively between the two groups (p = 0.45). The plus numbers of prism diopters represent exodeviation and the minus numbers of prism diopters represent esodeviation.

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