Similar pterygium outcomes regardless of surgeons’ level of expertise

Analysis finds acceptable outcomes can be expected when pterygium surgery is performed by a supervised ophthalmology resident.

John P. Thompson, MD, and colleagues from the Department of Ophthalmology, Louisiana State University at New Orleans, New Orleans, and the Department of Ophthalmology, University of Texas Health at San Antonio, San Antonio, reported that the experience level of the physicians performing pterygium does not impact the recurrence rate of the lesion, that is, the recurrences rates between attending physicians and supervised trainee residents were similar.

This retrospective analysis1 included primary pterygium surgeries that were performed by trainee residents and attending physicians in an academic institution in South Texas from 2008 to 2019. All residents who performed the surgeries were supervised directly by attending physicians. All patients had a minimal follow-up of 6 months postoperatively.

Pterygium results

A total of 240 eyes (229 patients; mean age, 55.6 ± 12.3 years; range, 28–91 years) were included. Attending physicians performed 100 surgeries that included 87 surgeries in which a conjunctival autograft was used and 13 surgeries in which an amniotic membrane graft was used. Trainee residents performed 140 surgeries that included 119 surgeries in which a conjunctival autograft was used and 21 surgeries in which an amniotic membrane graft was used.

The researchers reported that there were no significant differences between the 2 groups of patients regarding age, sex, and surgical technique. The average follow-up period was 19.8 ± 15.2 months.

In addition, the rates of recurrences of the pterygia did not differ between the experience levels of the surgeons when conjunctival autografts were used (6.8% vs. 10.0%, respectively, for attendings and trainees; p = 0.42) or when amniotic membrane grafts were used (69.2% vs. 47.6%, respectively; p = 0.22). Significant differences also were not found in other postoperative complications between the groups.

The study concluded, “Pterygium recurrence rates were similar between attending physicians and supervised trainee residents. Thus, acceptable outcomes can be expected when pterygium surgery is performed by a supervised ophthalmology resident.”

Reference
  1. Thompson JP, Harbin Z, Hrishikesh D, et al. Comparison of pterygium recurrence rates between attending physicians and supervised trainee residents. Cornea. 2022;41:12-15; doi: 10.1097/ICO.0000000000002721