title: ROYAL COLLEGE OF OPHTHALMOLOGISTS' NATIONAL DATABASE STUDY OF VITREORETINAL SURGERY: Report 7, Intersurgeon Variations in Primary Rhegmatogenous Retinal Detachment Failure.
abstract: OBJECTIVE
  To audit variations in primary rhegmatogenous retinal detachment (RD) anatomical failure rates between surgeons, grades of surgeons, and techniques of RD surgery.
  
  
  METHODS
  Clinical data of a total of 5,857 eyes undergoing primary RD surgery, from 2000 to 2013 were retrospectively extracted from 15 centers using the same commercially available electronic medical record system, from three vitreoretinal units using an in-house electronic medical record, and from the British and Eire Association of Vitreoretinal Surgeons online registry.
  
  
  RESULTS
  The 5,857 primary RD operations were performed by 117 surgeons: 3,349 (57.2%) by consultants, 520 (8.9%) by independent nonconsultants, and 1,988 (33.9%) by trainees. Surgery comprised pars plana vitrectomy for 4,666 (79.7%) operations, scleral buckle for 815 (13.9%), and pars plana vitrectomy + scleral buckle for 376 (6.4%). The RD reoperation rate at 6 months after primary surgery was 13.9% (725/5,202) and did not differ significantly between consultants and trainees (P = 0.382). For surgeons contributing ≥50 cases, the mean (range) reoperation rates were 13.1% (6.7%-26.8%), 15.1% (11.3%-18.2%), and 15.3% (9.4%-22.1%) for consultants, independent nonconsultants, and trainee surgeons, respectively. The scleral buckle failure rate was not significantly different from pars plana vitrectomy (P = 0.095). Data were not adjusted for case-mix complexity.
  
  
  CONCLUSIONS
  The grades of surgeons and the technique of surgery were not associated with a significant difference in primary unadjusted RD failure rates.
authors.affiliation: Ophthalmology Department, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, United Kingdom.|Jones Eye Institute, University of Arkansas for Medical Sciences.
authors.forename: Ahmed B
authors.initials: AB
authors.lastname: Sallam
authors.affiliation: Ophthalmology Department, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, United Kingdom.|National Ophthalmology Database, The Royal College of Ophthalmologists', London, United Kingdom.
authors.forename: Paul H J
authors.initials: PHJ
authors.lastname: Donachie
authors.affiliation: National Ophthalmology Database, The Royal College of Ophthalmologists', London, United Kingdom.|Ophthalmology Department, Gartnavel General Hospital, Glasgow, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Yorston
authors.affiliation: National Ophthalmology Database, The Royal College of Ophthalmologists', London, United Kingdom.|Sunderland Eye Infirmary, Sunderland, United Kingdom.|Institute of Genetic Medicine, University of Newcastle Upon Tyne, Newcastle, United Kingdom.
authors.forename: David H W
authors.initials: DHW
authors.lastname: Steel
authors.affiliation: National Ophthalmology Database, The Royal College of Ophthalmologists', London, United Kingdom.|Ophthalmology Department, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom.
authors.forename: Tom H
authors.initials: TH
authors.lastname: Williamson
authors.affiliation: Ophthalmology Department, King's College London, London, United Kingdom.
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Jackson
authors.affiliation: National Ophthalmology Database, The Royal College of Ophthalmologists', London, United Kingdom.|Bristol Eye Hospital, Bristol, United Kingdom.
authors.forename: John M
authors.initials: JM
authors.lastname: Sparrow
authors.affiliation: Ophthalmology Department, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, United Kingdom.|National Ophthalmology Database, The Royal College of Ophthalmologists', London, United Kingdom.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Johnston
mesh_terms: D000328:Adult; D016208:Databases, Factual / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072163:Ophthalmologists / Q000706:statistics & numerical data*; D009885:Ophthalmology / Q000458:organization & administration*; D011183:Postoperative Complications / Q000453:epidemiology*; D012042:Registries; D012163:Retinal Detachment / Q000601:surgery*; D012189:Retrospective Studies; D012955:Societies, Medical / Q000706:statistics & numerical data*; D017211:Treatment Failure; D006113:United Kingdom / Q000453:epidemiology; D057586:Vitreoretinal Surgery