Abstract ID: 26-231
Learning Curve in Oculoplastic Surgery
Author: Yuki Kamiya Base Hospital / Institution: Asahikawa Medical University/Oculo Facial Clinic Group
Presentation Type: ePoster Presentation
Purpose
Operative time is a common surrogate for surgical proficiency. While learning curves are well described in cataract surgery, quantitative analyses in oculoplastic procedures are limited. This study aimed to characterize the learning curves of levator advancement (LA) and blepharoplasty (BP), and to evaluate inter-surgeon and inter-procedure differences, including cases required to achieve proficiency.
Methods
This retrospective study included consecutive cases performed between April 2023 and March 2025 at a single oculofacial clinic group. Four novice surgeons (A–D) with no prior oculoplastic experience were included. Operative times during the first year were analyzed. Learning curves were modeled using the Wright model, and learning rates (LR) were calculated. Inter-surgeon differences were assessed using analysis of variance and Welch’s test, while differences in LRs were evaluated using analysis of covariance. Early (first 10 cases) and later cases were compared using Welch’s t-test. Proficiency was defined as the inflection point identified by cumulative sum (CUSUM) analysis. Statistical significance was set at p < 0.05.
Results
A total of 611 cases (LA, 348; BP, 263) were analyzed. Mean operative time was 68.4 ± 15.6 minutes for LA and 57.6 ± 15.2 minutes for BP. Learning rates for LA ranged from 92.1% to 92.8%, showing minimal inter-surgeon variability. In contrast, BP demonstrated lower learning rates (86.4%–90.6%), indicating a steeper learning curve, although differences were not statistically significant. Operative time significantly decreased from the first 10 cases to later cases for both procedures (p < 0.01). BP showed earlier stabilization and lower variability than LA. CUSUM analysis indicated that proficiency was achieved after 32–71 cases for LA and 20–38 cases for BP.
Conclusion
Blepharoplasty demonstrated greater learning efficiency than levator advancement, requiring fewer cases to achieve proficiency. Combined use of the Wright model and CUSUM analysis provides a robust framework for evaluating surgical learning curves and may inform training programs.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Tomoyuki | Kashima | Oculo Facial Clonic Group |
| Taiji | Nagaoka | Asahikawa medical University |