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. 2022 May 2:16:1365-1373.
doi: 10.2147/OPTH.S359384. eCollection 2022.

Ophthalmology Resident Ophthalmic Trauma Case Exposure: Trends Over Time and an ACGME Case Log Analysis

Mya Abousy  1 , Andy Schilling  1 , Mary Qiu  2 , Grant A Justin  3 , Fatemeh Rajaii  1 , Ximin Li  1 , Fasika A Woreta  1
Affiliations

Ophthalmology Resident Ophthalmic Trauma Case Exposure: Trends Over Time and an ACGME Case Log Analysis

Mya Abousy et al. Clin Ophthalmol. .

Abstract

Purpose: To describe ophthalmology resident experience with ophthalmic trauma cases in the U.S. .

Methods: We analyzed Accreditation Council for Graduate Medical Education (ACGME) case log data and de-identified case logs from US ophthalmology residency programs for residents graduating in 2018. Current Procedural Terminology (CPT) codes documented as "Globe Trauma" and trauma-related "Oculoplastic and Orbit" codes including lid lacerations and lateral canthotomies were analyzed.

Results: 38 residency programs provided case logs (response rate: 32.2%). Residents performed an average of 7.24±4.37 open globe repairs, 8.66±6.94 lid laceration repairs, 0.49±1.4 orbital fracture repairs, 1.22±1.81 lateral canthotomies, and 0.28±0.69 anterior chamber washouts as primary surgeon. On average, the most logged "Globe Trauma" procedure was open globe repair as primary surgeon. The more common trauma-related "Oculoplastic and Orbit" procedure was lid laceration repair as primary surgeon. 42.8% of residents did not log any lateral canthotomy procedures. Medium programs performed significantly more canthotomies than large programs (F(2166) = 6.35, p = 0.002), and large programs performed significantly more orbital fracture repairs than small and medium programs (F(2166) = 4.45, p = 0.013).

Conclusion: Significant variation in globe trauma volume exists across programs. ACGME guidelines require a minimum of four globe trauma procedures for graduation, but procedures like anterior chamber paracentesis count towards this requirement. Open globe repairs, simple lid lacerations, and lateral canthotomies are basic skills every graduating resident should be competent in. Updating ACGME case log requirements for ophthalmic trauma and increasing opportunities for wet lab simulations may assist in ensuring graduating ophthalmology residents' competency in performing these procedures.

Keywords: ACGME; education; globe trauma; residency; surgical education.

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Conflict of interest statement

This work was supported by the NIH grant P30EY001765: Wilmer Biostats Core. Dr Fatemeh Rajaii is a consultant and shareholder for Horizon Therapeutics outside the submitted work. The authors report no other conflicts of interest in this work.

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