[Analysis on ophthalmic human resource allocation and service delivery at county level in Mainland China in 2014].

Objective: To master the status of ophthalmic human resource allocation and service delivery at county level in Mainland China, and to provide the basis for strengthening the construction of grassroots ophthalmic personnel team and formulating feasible medium and long-term eye health plans. Methods: All the medical institutions that provided ophthalmic service at county level or above were investigated by online reporting. This study only included medical institutions at county level. Descriptive statistics were used. Results: Three thousand three hundred and fifty-nine medical institutions were included, of which 1 463 hospitals had independent departments of ophthalmology (43.55%). Each medical institution has 3.93 ophthalmologists, 4.59 ophthalmic nurses, 0.30 full-time optometrist and 0.21 full-time optician. Ophthalmologists are mainly undergraduate, and the ratio of senior, intermediate and junior titles is 1.0∶1.7∶1.9. The ophthalmic nurses are mainly graduated from junior colleges or secondary schools, and the ratio of senior, intermediate and junior titles is 1.0∶7.3∶22.3. There were statistically differences in the distribution of job titles of ophthalmologists (χ(2)=106.21, P<0.01) and nurses (χ(2)=128.54, P<0.01) in the eastern, central and western regions. Of each ophthalmologist, the annual number of outpatient, outpatient surgery, inpatient and inpatient operation was 2 377.62, 109.79, 124.03, and 85.97 respectively. Four thousand one hundred and sixty ophthalmologists were able to carry out cataract surgeries independently, accounting for 31.50% of all ophthalmologists. The quantity for annual per capita cataract operation among ophthalmologists who can perform cataract surgery independently was 181.81 per capita. The average beds rate of utilization was 68.91%, and that was less than 60% in 52.99% of medical institutions. Conclusions: Compared with 1998, ophthalmic health personnel at county level in Mainland China has expanded rapidly. But cataract ability of ophthalmologists and the number of cataract surgeries still need to be improved. The structure of ophthalmic nursing staff is irrational. The full-time optometrists and opticians are extremely scarce. It is necessary to cultivate high-quality ophthalmic health personnel and improve beds rate of utilization at county level. (Chin J Ophthalmol, 2018, 54:929-934).

Effects of Surgical Assistant's Level of Resident Training on Surgical Treatment of Intermittent Exotropia: Operation Time and Surgical Outcomes.

PURPOSE: To evaluate the effects of the surgical assistant's level of resident training on operation time and surgical outcome in the surgical treatment of intermittent exotropia. METHODS: This study included 456 patients with intermittent exotropia who underwent lateral rectus recession and medial rectus resection and were followed up for 24 months after surgery. The patients were divided into two groups according to the surgical assistant's level of resident training: group F (surgery assisted by a first-year resident [n = 198]) and group S (surgery assisted by a second-, third-, or fourth-year resident [n = 258]). The operation time and surgical outcomes (postoperative exodeviation and the number of patients who underwent a second operation) were compared between the two groups. RESULTS: The average operation times in groups F and S were 36.54 ± 7.4 and 37.34 ± 9.94 minutes, respectively (p = 0.33). Immediate postoperative exodeviation was higher in group F (0.79 ± 3.82 prism diopters) than in group S (0.38 ± 3.75 prism diopters). However, repeated-measures analysis of variance revealed no significant difference in exodeviation between the two groups during the 24-month follow-up period (p = 0.45). A second operation was performed in 29.3% (58 / 198) of the patients in group F, and in 32.2% (83 / 258) of those in group S (p = 0.51). CONCLUSIONS: No significant difference in operation time was observed when we compared the effects of the level of resident training in the surgical treatment of intermittent exotropia. Although the immediate postoperative exodeviation was higher in patients who had undergone surgery assisted by a first-year resident, the surgical outcome during the 24-month follow-up was not significantly different.

Effects of Surgical Assistant's Level of Resident Training on Surgical Treatment of Intermittent Exotropia: Operation Time and Surgical Outcomes

PURPOSE: To evaluate the effects of the surgical assistant's level of resident training on operation time and surgical outcome in the surgical treatment of intermittent exotropia. METHODS: This study included 456 patients with intermittent exotropia who underwent lateral rectus recession and medial rectus resection and were followed up for 24 months after surgery. The patients were divided into two groups according to the surgical assistant's level of resident training: group F (surgery assisted by a first-year resident [n = 198]) and group S (surgery assisted by a second-, third-, or fourth-year resident [n = 258]). The operation time and surgical outcomes (postoperative exodeviation and the number of patients who underwent a second operation) were compared between the two groups. RESULTS: The average operation times in groups F and S were 36.54 ± 7.4 and 37.34 ± 9.94 minutes, respectively (p = 0.33). Immediate postoperative exodeviation was higher in group F (0.79 ± 3.82 prism diopters) than in group S (0.38 ± 3.75 prism diopters). However, repeated-measures analysis of variance revealed no significant difference in exodeviation between the two groups during the 24-month follow-up period (p = 0.45). A second operation was performed in 29.3% (58 / 198) of the patients in group F, and in 32.2% (83 / 258) of those in group S (p = 0.51). CONCLUSIONS: No significant difference in operation time was observed when we compared the effects of the level of resident training in the surgical treatment of intermittent exotropia. Although the immediate postoperative exodeviation was higher in patients who had undergone surgery assisted by a first-year resident, the surgical outcome during the 24-month follow-up was not significantly different.