title: Learning curve of the scleral buckling operation: lessons from the first 97 cases.
abstract: OBJECTIVE
  To provide an insight into the learning curve associated with scleral buckling surgery for an ophthalmologist on a fellowship course and to evaluate risk factors affecting outcomes during this period.
  
  
  METHODS
  Retrospective data were collected on 97 consecutive scleral buckling procedures (divided into 3 consecutive groups) performed by one surgeon (W.C.) beginning his first fellowship year. We evaluated the anatomic results, operative times and complications, and sought to identify risk factors of anatomic failure.
  
  
  RESULTS
  The single-operation success rate was 71.9% (23 of 32 eyes) in the first group, which was lower than 87.5% (28 of 32 eyes) in the second and 84.8% (28 of 33 eyes) in the third. The operative time was 106.3 min in the first, which is longer than 86.5 min in the second and 73.8 min in the third group. Factors predictive of unfavorable anatomic outcome were multiple breaks and multiple buckling procedures in the first 32 cases, and multiple breaks and breaks located posterior to the equator in the latter 65.
  
  
  CONCLUSIONS
  Surgical experience of approximately 30 cases was required to achieve stable clinical results. Thus, a retinal surgeon at the beginning of his career may increase his success rate by careful case selection avoiding high-risk groups until he reaches the level of experience indicated by the learning curve.
authors.affiliation: Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Min
authors.initials: M
authors.lastname: Sagong
authors.forename: Woohyok
authors.initials: W
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002983:Clinical Competence; D005257:Fellowships and Scholarships; D005260:Female; D013502:General Surgery / Q000193:education*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009885:Ophthalmology / Q000193:education*; D012163:Retinal Detachment / Q000453:epidemiology / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D012591:Scleral Buckling / Q000009:adverse effects / Q000193:education* / Q000706:statistics & numerical data; D055815:Young Adult