Learning curves for strabismus surgery in two ophthalmologists

Abstract

PurposeTo identify the average turning point by comparing the learning curves of two surgeons learningto perform strabismus surgery.MethodsPatients who underwent procedures to correctexotropia between January 2010 and December 2014 followed for at least 3 months were retrospectivelyassessed. The first 70 patients on whom each of two ophthalmologists (A and B) performed surgery to treatstrabismus were divided into 7 cohorts comprising 10 patients each based on the chronological order ofthe surgery. Factors, including patient age, preoperative angle of deviation, operative time, and success orfailure of the operation, were compared between the two surgeons. Learning curves were calculated basedon changes in operative time and operation success rate. Operation success was determined by measuringthe angle of deviation at a distance of 5 m 3 months after the operation.ResultsA turning point wasobserved after 40 cases for Surgeon A and 50 cases for Surgeon B based on the operative time learning curve. No turning point was observed in the operation success rate learning curve based on the absence of a specifictrend. Success rate by cohort was not significantly different between the two surgeons (p > 0.05). Surgeon B had a significantly longer mean operative time than Surgeon A (p = 0.045).ConclusionsApproximately 50 cases are required for an ophthalmologist to reach a turning point in strabismus surgery. This outcomecan be used as a guideline when training surgeons to perform strabismus surgery.