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Jiao C, Patel PA, Ibnamasud S, Patel PN, Ahmed H, Law JC. Descriptive Analysis of Vitreoretinal Surgery Fellowship Program Directors. JOURNAL OF VITREORETINAL DISEASES 2024; 8:280-285. [PMID: 38770078 PMCID: PMC11102720 DOI: 10.1177/24741264241230385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
Purpose: To evaluate the demographic, educational, and scholarly characteristics of Association of University Professors of Ophthalmology-accredited vitreoretinal surgery fellowship program directors in the United States and Canada. Methods: Demographic, educational, and scholarly profiles of identified program directors were collated from online public resources. Characteristics were compared by sex, program size, ranking, and affiliation. Results: Eighty-one program directors (mean age [±SD] 54.7 ± 11.0 years) from 78 fellowship programs were identified. The minority were women (14.8%), who were on average 6 years younger than their male counterparts (P = .07). The majority of program directors had an academic affiliation (90.1%), most commonly professor (54.8%). The mean h-index, 5-year h-index, and m-quotient were 20.9 ± 14.9, 5.9 ± 4.4, and 0.82 ± 0.42, respectively. Compared with their counterparts, program directors of both "top 10" and large programs published more manuscripts (P < .05), accrued more citations (P < .05), and had a higher h-index (P < .05). Fellowship programs with female program directors had a significantly larger proportion of female retina faculty (P = .002). Conclusions: The backgrounds of vitreoretinal surgery program directors are diverse. However, women remain underrepresented in this position, highlighting an area with the potential for greater equity in ophthalmology.
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Affiliation(s)
- Cheng Jiao
- Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Parth A. Patel
- Medical College of Georgia, Augusta University, Augusta, GA, USA
| | | | - Prem N. Patel
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Harris Ahmed
- Department of Ophthalmology, Loma Linda University Medical Center, Loma Linda, CA, USA
| | - Janice C. Law
- Department of Ophthalmology, Vanderbilt University Medical Center, Nashville, TN, USA
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Ong SS, Ahmed I, Gonzales A, Aguwa UT, Beatson B, Dai X, Pham AT, Shah YS, Zhou A, Arsiwala LT, Wang J, Handa JT. Management of uncomplicated rhegmatogenous retinal detachments: a comparison of practice patterns and clinical outcomes in a real-world setting. Eye (Lond) 2023; 37:684-691. [PMID: 35338355 PMCID: PMC9998441 DOI: 10.1038/s41433-022-02028-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/22/2022] [Accepted: 03/11/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To investigate practice patterns and clinical outcomes in the repair of uncomplicated rhegmatogenous retinal detachments (RRD) in a real-world setting over a 10-year period. METHODS We compared preferences for scleral buckling (SB), pars plana vitrectomy (PPV), PPV/SB, or pneumatic retinopexy (PR) over time, and examined the 1-year single surgery anatomic success (SSAS) and best-corrected visual acuity (BCVA) at a tertiary academic institution from 2008-2018. RESULTS Eight hundred eight eyes had RRD repair between 2008-2011 (n = 240), 2012-2014 (n = 271), and 2015-2017 (n = 297). Compared to 2008-2011, PPV was preferred over SB in 2012-2014 (OR: 2.93; 95% CI: 1.86-4.63) and 2015-2017 (OR: 5.94; 95% CI: 3.76-9.38), and over PPV/SB in 2012-2014 (OR: 2.74; 95% CI: 1.65-4.56) and 2015-2017 (OR: 3.16; 95% CI: 31.96-5.12). PR was uncommonly utilized (<10%). Younger surgeons (graduating 2010-2017) favored PPV over SB when compared to older surgeons [graduating 1984-2000 (OR: 1.77; 95% CI: 1.18-2.65) and 2001-2009 (OR 1.73; 95% CI: 1.14-2.65)], but similarly selected PPV vs. PPV/SB as their older counterparts (p > 0.05). Compared to PPV, SSAS was higher with SB (OR: 1.53; 95% CI: 1.03-2.26) and PPV/SB (OR: 2.55; 95% CI: 1.56-4.17). One-year BCVA was markedly improved compared to baseline only for eyes that achieved SSAS (p < 0.001). CONCLUSIONS Over the past 10 years, PPV has become the favored approach to repair uncomplicated RRD and this appears to be driven by younger surgeons' preferences. Given the superior long-term SSAS in SB and PPV/SB as compared to PPV, SB and PPV/SB should be more frequently considered when determining the appropriate repair strategy for uncomplicated RRD.
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Affiliation(s)
- Sally S Ong
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Ophthalmology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Ishrat Ahmed
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Anthony Gonzales
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Ugochi T Aguwa
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Bradley Beatson
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Xi Dai
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Alex T Pham
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Yesha S Shah
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Ashley Zhou
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Lubaina T Arsiwala
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Jiangxia Wang
- Johns Hopkins Biostatistics Center, Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - James T Handa
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA.
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Burton E, Mishra K, Arsiwala LT, Zafar S, Justin GA, Mruthyunjaya P, Woreta FA. Applicant Characteristics Associated with Retina Fellowship Match from 2010-2019. Ophthalmol Retina 2022; 6:1253-1259. [PMID: 35772695 PMCID: PMC9887683 DOI: 10.1016/j.oret.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 06/18/2022] [Accepted: 06/21/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe trends in the surgical and medical retina fellowship match and applicant characteristics associated with matching in retina fellowship. DESIGN Retrospective study. SUBJECTS Ophthalmology fellowship applicants who applied through the San Francisco (SF) Match. METHODS Publicly available SF Match data were used to describe trends in the number of programs participating and positions offered, filled, and left vacant in the retina fellowship match from 2014 to 2019. Deidentified applicant data for match cycles from 2010 to 2017 were stratified by match status, and characteristics were compared across groups. Trends in matched applicant characteristics were evaluated using linear regression on log-transformed variables. Multivariable logistic regression was used to determine applicant characteristics that were associated with a successful match. MAIN OUTCOME MEASURES Match status. RESULTS From 2014 to 2019, the number of programs participating, positions filled, and positions left vacant in the retina fellowship match increased from 101 to 119 (P = 0.010), 118 to 123 (P = 0.078), and 18 to 37 (P = 0.045), respectively. Compared with unmatched applicants, matched applicants were more likely to have graduated from a top 10 residency program, US residency, or medical school; hold a United States (US) visa (J-1, H-1B, or O1); distribute more applications; complete more interviews; rank more programs; and score higher on the United States Medical Licensing Examination (USMLE) Step examinations 1-3. Matched applicants completed a median of 10 interviews. After controlling for potential covariates, graduating from a US residency (odds ratio [OR], 2.08; 95% confidence interval [CI], 1.48-2.92), a top 10 residency (OR, 1.74; 95% CI, 1.07-2.84), having an allopathic medical degree (MD; OR, 2.39; 95% CI, 1.08-5.33), completing more interviews (OR, 1.28; 95% CI, 1.23-1.33), and scoring higher on USMLE Step 3 (OR, 1.01; 95% CI, 1.01-1.03) were associated with matching into a retina fellowship. CONCLUSIONS Although the number of programs participating and positions offered in the retina fellowship match are increasing, the number of positions filled remained relatively stagnant. Factors associated with matching in both medical and surgical retina included graduating from a US and top 10-ranked residency program, having an MD, completing more interviews, and scoring higher on USMLE Step 3.
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Affiliation(s)
- Eleanor Burton
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kapil Mishra
- Byers Eye Institute, Stanford University, Palo Alto, California
| | - Lubaina T Arsiwala
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sidra Zafar
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Grant A Justin
- Vitreoretinal Surgery Service, Duke Eye Center, Durham, North Carolina
| | | | - Fasika A Woreta
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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Experience gained during vitreoretinal fellowships in the United Kingdom. Eye (Lond) 2022; 37:1479-1483. [PMID: 35821251 PMCID: PMC9273700 DOI: 10.1038/s41433-022-02168-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/23/2022] [Accepted: 06/28/2022] [Indexed: 12/04/2022] Open
Abstract
Background There are 16 vitreoretinal (VR) fellowships listed on the British and Eire Association of Vitreoretinal Surgeons (BEAVRS) website offering places to 23 applicants, however, this list is not exhaustive. The purpose of this survey was to evaluate surgical volume, training, and experience of VR fellows in the UK. Methods An anonymous survey was disseminated online to current and past VR fellows who are members of BEAVRS. Participants were asked about their surgical experience and confidence, before and during their fellowship, in performing a variety of procedures. Participants were also asked about their academic achievements and their career prospects. Results All 26 respondents felt that their fellowship met their surgical needs and would recommend it to others. Upon completion, 92% felt prepared to work as a consultant. Following fellowship completion, the median (IQR) number of procedures performed were: phacoemulsification: 91 (51–131), pars-plana vitrectomy (PPV): 351 (226–451), simple-retinal detachment (RD): 176 (126–226), complex-RD: 31 (16–51), scleral buckle (SB): 16 (80–26), membrane-peels: 76 (41–88), intraocular-foreign body (IOFB) removal: 3 (3–3), indirect laser: 51 (11–91), scleral-fixated intraocular-lens (sfIOL): 3 (3–8), removal-of-dropped-nucleus (RODN): 16 (8–26), diabetic membrane delaminations: 16 (8–16); with an increase of confidence in performing all VR procedures (p < 0.001). Participants completed 2 (1–2) presentations and 2 (0–3) papers with no difference in academic performance between those with/without postgraduate qualifications (p = 0.409). Conclusions Overall, fellowships in the UK are of a high quality and prepare the fellow adequately for progression into a consultant post. They help increase surgical confidence and provide opportunities to complete academic work. Fellowships without VR on-call commitments can be improved by incorporating on-call duties. Finally, COVID-19 impacted exposure to elective cases.
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Ong SS, Ahmed I, Gonzales A, Al-Fakhri AS, Al-Subaie HF, Al-Qhatani FS, Alsulaiman SM, Mura M, Maia M, Kondo Kuroiwa DA, Maia NT, Berrocal MH, Wu L, Zas M, Francos JP, Cubero-Parra JM, Arsiwala LT, Handa JT, Arevalo JF. Vitrectomy versus Vitrectomy with Scleral Buckling in the Treatment of Giant Retinal Tear Related Retinal Detachments: An International Multicenter Study. Ophthalmol Retina 2022; 6:595-606. [PMID: 35304304 DOI: 10.1016/j.oret.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/26/2022] [Accepted: 03/09/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE To determine the practice pattern for treating giant retinal tear (GRT) related detachments, and their anatomic and visual outcomes with pars plana vitrectomy (PPV) with or without scleral buckling (SB). DESIGN Retrospective cohort study. SUBJECTS Eyes with GRT detachments repaired from 2008-2020 with at least 6 months of follow-up from seven institutions in North and South America, Europe, and Asia. METHODS Eyes repaired using PPV versus PPV/SB were compared. MAIN OUTCOME MEASURES Anatomic and functional outcomes. RESULTS A comparable number of eyes underwent PPV (n=101) and PPV/SB (n=99). Except for prior intraocular surgery and lens status, no differences in baseline demographics, ocular characteristics, or intraoperative surgical adjuncts were observed. Overall single surgery anatomic success (SSAS) at 6 months and 1 year was similar between the groups (82.2% and 77.2% of PPV, and 87.9% and 85.7% of PPV/SB). However, when stratified by age, the 1-year SSAS rate was higher for PPV/SB (88.5%) than PPV (56.3%) (p=0.03) for children < 18 years. For both children and adults, mean best corrected visual acuity (BCVA) at baseline did not differ between the PPV and PPV/SB groups. However, for children, mean BCVA at 1 year was better in the PPV/SB than PPV groups (p=0.001) while for adults, no difference was found between the two groups. The mean time to first redetachment was 7.9 months in the PPV group and 5.5 months in the PPV/SB group (p=0.8). PVR was the most common cause for redetachment (70.4% of PPV and 93.8% of PPV/SB in redetached eyes; p=0.1). Postoperative complications were also similar between the two groups including ocular hypertension, epiretinal membrane, and cataract. CONCLUSIONS PPV and PPV/SB are equally popular among surgeons globally for managing GRT detachments and have comparable anatomic and visual outcomes in adults. In children, PPV/SB is superior to PPV for anatomic and functional success at one year. In adults, the relief of traction by the GRT may reduce peripheral traction and obviate the need for a SB. However, in children, a supplemental SB can be beneficial as complete vitreous shaving and posterior hyaloid detachment, and postoperative positioning are difficult in this group.
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Affiliation(s)
- Sally S Ong
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland; Department of Ophthalmology, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Ishrat Ahmed
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Anthony Gonzales
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
| | | | - Hamad F Al-Subaie
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Faisal S Al-Qhatani
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | | | - Marco Mura
- Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Mauricio Maia
- Vitreoretinal Surgery, Federal University of Sao Paulo, Brazil
| | | | | | | | - Lihteh Wu
- Asociados de Macula, Vitreo y Retina de Costa Rica, San Jose, Costa Rica
| | - Marcelo Zas
- Sección Retina, Hospital de Clínicas de la Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Juan Pablo Francos
- Sección Retina, Hospital de Clínicas de la Universidad de Buenos Aires, Buenos Aires, Argentina
| | | | - Lubaina T Arsiwala
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland; Wilmer Biostatistics Center, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - James T Handa
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - J Fernando Arevalo
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland.
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Affiliation(s)
- Manavi D Sindal
- Vitreo-Retina Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry, India
| | - Kanika Chhabra
- Vitreo-Retina Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Pondicherry, India
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