Clinical Ophthalmology (May 2021)
Analysis of Complications for Epiretinal Membrane and Macular Hole Surgery Performed by Vitreoretinal Fellows and Consultants
Abstract
Saud Aljohani,1,2 Abdulaziz Alshehri,1,3 Abdulaziz Al Taisan,1,4 Rakan Algorinees,1,5 Valmore A Semidey1 1King Khaled Eye Specialist Hospital, Riyadh, Kingdom of Saudi Arabia; 2King Fahad University Hospital, Alkhobar, Kingdom of Saudi Arabia; 3Altaif University, Al-Taif, Saudi Arabia; 4King Faisal University, Al-Ahsa, Saudi Arabia; 5University of Ha’il, Ha’il, Saudi ArabiaCorrespondence: Valmore A SemideyVitreoretinal Division, King Khaled Eye Specialist Hospital, Al- Oruba Street, PO Box 7191, Riyadh, 11462, Kingdom of Saudi ArabiaTel +966 11 482 1234 Ext. 2655Fax +966 11 4821234 Ext. 3773Email [email protected]: The aim of this study was to report the intraoperative and postoperative complications of vitrectomy for epiretinal membrane (ERM) and macular hole (MH) performed by retinal fellows under direct faculty supervision compared with experienced faculty members.Patients and Methods: A total of 271 eyes that underwent pars plana vitrectomy (PPV) for MH and ERM from January 2014 to December 2019 at King Khaled Eye Specialist Hospital were analyzed. PPV for ERM and MH was performed by vitreoretinal fellows and consultants.Results: The outcome measures assessed were the intraoperative complications rates, such as posterior lens touch, retinal breaks (RBs), retinal detachments, and vitreous hemorrhage. Moreover, the postoperative complications and optical coherence tomography (OCT) changes were assessed upon a minimum follow-up of 6 months. The rate of iatrogenic RB was more common in the ERM than in the MH surgery (15.5% vs 11.2%). Fellows and consultants had a rate of 20.5% of RB during the ERM surgery and 14.6% during MH surgery, respectively. However, these differences were not statistically significant (p = 0.12 for MH and p = 0.236 for ERM). Postoperative OCT analysis revealed an MH closure rate of 72.2%, and complete removal of the ERM was achieved in 88.6% in cases performed by fellows, while consultants achieved 61.8% closure rate of MH, and 83.3% of the patients achieved complete removal of ERM.Conclusion: Macular surgery is overall a safe procedure and the complication rates between fellows and consultants are comparable. With proper supervision, vitreoretinal fellows can achieve equally high anatomical outcomes with few complications.Keywords: epiretinal membrane, fellows, macular hole, pars plana vitrectomy, retinal break
