Quantifying surgical skill in macular surgery

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt

Standard

Quantifying surgical skill in macular surgery. / Alberti, Mark; Jacobsen, Mads Forslund; Hermann, Martin Nissen; Konge, Lars; Christensen, Ulrik Correll; Thomsen, Ann Sofia Skou; la Cour, Morten.

I: Acta Ophthalmologica, Bind 100, Nr. 4, 2022, s. 440-446.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt

Harvard

Alberti, M, Jacobsen, MF, Hermann, MN, Konge, L, Christensen, UC, Thomsen, ASS & la Cour, M 2022, 'Quantifying surgical skill in macular surgery', Acta Ophthalmologica, bind 100, nr. 4, s. 440-446. https://doi.org/10.1111/aos.15023

APA

Alberti, M., Jacobsen, M. F., Hermann, M. N., Konge, L., Christensen, U. C., Thomsen, A. S. S., & la Cour, M. (2022). Quantifying surgical skill in macular surgery. Acta Ophthalmologica, 100(4), 440-446. https://doi.org/10.1111/aos.15023

Vancouver

Alberti M, Jacobsen MF, Hermann MN, Konge L, Christensen UC, Thomsen ASS o.a. Quantifying surgical skill in macular surgery. Acta Ophthalmologica. 2022;100(4):440-446. https://doi.org/10.1111/aos.15023

Author

Alberti, Mark ; Jacobsen, Mads Forslund ; Hermann, Martin Nissen ; Konge, Lars ; Christensen, Ulrik Correll ; Thomsen, Ann Sofia Skou ; la Cour, Morten. / Quantifying surgical skill in macular surgery. I: Acta Ophthalmologica. 2022 ; Bind 100, Nr. 4. s. 440-446.

Bibtex

@article{c536bea25af34fe786957d1f6e78629d,

title = "Quantifying surgical skill in macular surgery",

abstract = "Purpose: To evaluate the relationship between patient outcome and surgical experience by developing an objective quality measure of macular hole surgery based on forceps damage to the inner retina. Methods: We retrospectively examined 3 macular hole case series >1 year after pars plana vitrectomy, internal limiting membrane peeling and gas tamponade. The patients were operated by (1) a novice surgeon (<20 cases), (2) an intermediate (150+ cases) and (3) an experienced surgeon (2000+ cases). Primary outcome was inner retinal volume defect as segmented from optical coherence tomography (GCL++: thickness from internal limiting membrane to inner plexiform layer). Secondary outcome was retinal function measured by confocal microperimetry using a custom scanning protocol. Results: Thirty-two patients were examined: 11, 10 and 11 patients in the novice, intermediate and experienced surgeon group, respectively. Median GCL++ volume defect was 23.68 × 106 μm3 (IQR: 22.77 × 106–44.81 × 106 μm3), 8.42 × 106 μm3 (IQR: 4.86 × 106–10.03 × 106 μm3) and 3.55 × 106 μm3 (IQR: 1.44 × 103–7.94 × 106 μm3) in the novice, intermediate and experienced surgeon group, respectively (p = 0.0004). The novice surgeon volume defect differed significantly from the intermediate and experienced surgeon (p = 0.016 and p = 0.0002, respectively). A subset of 12 patients underwent microperimetry measurements demonstrating correlation between inner retinal volume defect and reduced retinal sensitivity (p = 0.02). Conclusions: Forceps induced inner retinal damage commonly occurs during initiation of internal limiting membrane peeling in macular hole surgery. Damage to the structure and function of the inner retina seems to correlate to surgical experience.",

keywords = "ILM peeling, macular hole, surgical training, vitreoretinal surgery",

author = "Mark Alberti and Jacobsen, {Mads Forslund} and Hermann, {Martin Nissen} and Lars Konge and Christensen, {Ulrik Correll} and Thomsen, {Ann Sofia Skou} and {la Cour}, Morten",

note = "Publisher Copyright: {\textcopyright} 2021 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.",

year = "2022",

doi = "10.1111/aos.15023",

language = "English",

volume = "100",

pages = "440--446",

journal = "Acta Ophthalmologica",

issn = "1755-375X",

publisher = "Wiley-Blackwell",

number = "4",

}

RIS

TY - JOUR

T1 - Quantifying surgical skill in macular surgery

AU - Alberti, Mark

AU - Jacobsen, Mads Forslund

AU - Hermann, Martin Nissen

AU - Konge, Lars

AU - Christensen, Ulrik Correll

AU - Thomsen, Ann Sofia Skou

AU - la Cour, Morten

PY - 2022

Y1 - 2022

N2 - Purpose: To evaluate the relationship between patient outcome and surgical experience by developing an objective quality measure of macular hole surgery based on forceps damage to the inner retina. Methods: We retrospectively examined 3 macular hole case series >1 year after pars plana vitrectomy, internal limiting membrane peeling and gas tamponade. The patients were operated by (1) a novice surgeon (<20 cases), (2) an intermediate (150+ cases) and (3) an experienced surgeon (2000+ cases). Primary outcome was inner retinal volume defect as segmented from optical coherence tomography (GCL++: thickness from internal limiting membrane to inner plexiform layer). Secondary outcome was retinal function measured by confocal microperimetry using a custom scanning protocol. Results: Thirty-two patients were examined: 11, 10 and 11 patients in the novice, intermediate and experienced surgeon group, respectively. Median GCL++ volume defect was 23.68 × 106 μm3 (IQR: 22.77 × 106–44.81 × 106 μm3), 8.42 × 106 μm3 (IQR: 4.86 × 106–10.03 × 106 μm3) and 3.55 × 106 μm3 (IQR: 1.44 × 103–7.94 × 106 μm3) in the novice, intermediate and experienced surgeon group, respectively (p = 0.0004). The novice surgeon volume defect differed significantly from the intermediate and experienced surgeon (p = 0.016 and p = 0.0002, respectively). A subset of 12 patients underwent microperimetry measurements demonstrating correlation between inner retinal volume defect and reduced retinal sensitivity (p = 0.02). Conclusions: Forceps induced inner retinal damage commonly occurs during initiation of internal limiting membrane peeling in macular hole surgery. Damage to the structure and function of the inner retina seems to correlate to surgical experience.

AB - Purpose: To evaluate the relationship between patient outcome and surgical experience by developing an objective quality measure of macular hole surgery based on forceps damage to the inner retina. Methods: We retrospectively examined 3 macular hole case series >1 year after pars plana vitrectomy, internal limiting membrane peeling and gas tamponade. The patients were operated by (1) a novice surgeon (<20 cases), (2) an intermediate (150+ cases) and (3) an experienced surgeon (2000+ cases). Primary outcome was inner retinal volume defect as segmented from optical coherence tomography (GCL++: thickness from internal limiting membrane to inner plexiform layer). Secondary outcome was retinal function measured by confocal microperimetry using a custom scanning protocol. Results: Thirty-two patients were examined: 11, 10 and 11 patients in the novice, intermediate and experienced surgeon group, respectively. Median GCL++ volume defect was 23.68 × 106 μm3 (IQR: 22.77 × 106–44.81 × 106 μm3), 8.42 × 106 μm3 (IQR: 4.86 × 106–10.03 × 106 μm3) and 3.55 × 106 μm3 (IQR: 1.44 × 103–7.94 × 106 μm3) in the novice, intermediate and experienced surgeon group, respectively (p = 0.0004). The novice surgeon volume defect differed significantly from the intermediate and experienced surgeon (p = 0.016 and p = 0.0002, respectively). A subset of 12 patients underwent microperimetry measurements demonstrating correlation between inner retinal volume defect and reduced retinal sensitivity (p = 0.02). Conclusions: Forceps induced inner retinal damage commonly occurs during initiation of internal limiting membrane peeling in macular hole surgery. Damage to the structure and function of the inner retina seems to correlate to surgical experience.

KW - ILM peeling

KW - macular hole

KW - surgical training

KW - vitreoretinal surgery

U2 - 10.1111/aos.15023

DO - 10.1111/aos.15023

M3 - Journal article

C2 - 34549889

AN - SCOPUS:85115221752

VL - 100

SP - 440

EP - 446

JO - Acta Ophthalmologica

JF - Acta Ophthalmologica

SN - 1755-375X

IS - 4

ER -

ID: 312769925

Institut for Klinisk Medicin