Analysis of pediatric ophthalmology surgical activity in metropolitan France in 2016: Its impact on training capacities

Abstract

Aims: To describe pediatric ophthalmology surgery activity in private or public practice in metropolitan France in 2016 and to anticipate training needs in surgical pediatric ophthalmology.

Methods: We used the French National Health Care System database to identify all pediatric ophthalmology surgical procedures performed in 2016. The study included all children aged ≤14 years who had undergone ophthalmologic surgery. We calculated the incidence of surgeries per 100,000 inhabitants aged ≤14 years, the number of surgeons, the mean age of the practitioners, and the number of surgeons aged >55 years.

Results: In 2016, the overall incidence of pediatric ophthalmic surgery activity was 150.42/100,000 children aged ≤14 years. Out of 17,657 pediatric surgeries, 31.3 % were done by private surgeons performing at least 20 surgeries per year, 45.9 % in public centers with ≥20 surgeries per year, and 22.8 % by surgeons (public or private centers) doing <20 surgeries per year. This analysis included 204 surgeons, with a mean age of 41.7 ± 11.2 years (60.8 % female) in the public sector and 51.0 ± 9.5 years (37.3 % female) in private practice. More than a third of the surgeries (37.7 %) were performed in children aged 6-11 years, and the most frequent procedure was strabismus surgery (42.1 %). University regions with the fewest surgeons and regions with surgeons aged >55 years were identified. Within 5 years, to maintain pediatric ophthalmic surgical activity, it will be necessary to train 46 surgeons.

Conclusions: This study demonstrated disparities in the geographic distribution of pediatric ophthalmic surgeries in France and identified regions that need increased training capacities and/or incorporate new surgeons to ensure a sufficient activity.

Keywords: Epidemiology; Nationwide study; Pediatric ophthalmology; Strabismus; Surgery; Surgery education.