First-Year Fellow Single Surgery Success Rate in Primary Rhegmatogenous Retinal Detachments

Purpose: To evaluate the single surgery success rate (SSSR) of a first-year vitreoretinal surgery fellow managing primary rhegmatogenous retinal detachments (RRDs) under attending supervision.

Methods: A retrospective review of primary RRD cases performed by a first-year vitreoretinal fellow at Retina Associates of Cleveland Inc from July 1, 2023, to June 30, 2024 was conducted. Cases included pars plana vitrectomy (PPV) with gas endotamponade, excluding primary scleral buckles and combined procedures. The primary outcome was defined as successful retinal reattachment without additional surgical intervention within 3 months. Subgroup analysis excluded eyes with prior vitreoretinal surgery and complex cases such as proliferative vitreoretinopathy (PVR), giant retinal tears, choroidal detachments, or retinoschisis. Statistical analysis was performed using R and Microsoft Excel software. Chi-square testing was utilized to analyze the potential influence of attending surgeons on surgical outcomes.

Results: The overall SSSR was 91% (95% CI 84%, 96%), with 98 eyes successfully reattached after a single surgery. The reoperation rate within 3 months was 9%, and the overall reoperation rate was 10%. Excluding prior surgeries and complex cases, the SSSR improved to 94%. No significant differences in outcomes were observed across attending surgeons (p = 0.764). The fellow’s success rate was comparable to published SSSR rates among experienced retinal surgeons.

Conclusions: A first-year vitreoretinal fellow achieved a 91% SSSR in primary RRD repair, improving to 94% in less complex cases. These findings suggest that, under appropriate supervision, early surgical competency in vitreoretinal surgery can be achieved with outcomes comparable to attending surgeons.

Keywords: First-Year Vitreoretinal Fellow, Single Surgery Success Rate, Primary Rhegmatogenous Retinal Detachment, Pars Plana Vitrectomy, Retinal Reattachment, Surgical Competency.