Surgical Assistant Use in Vitreoretinal Surgery

Ophthalmol Retina. 2017 Jul-Aug;1(4):278-281. doi: 10.1016/j.oret.2016.12.013. Epub 2017 Apr 19.


Purpose: To evaluate the use of surgical assistants in vitreoretinal surgery.

Design: Database study.

Participants: Data from US Medicare Part B fee-for-service beneficiaries and their providers.

Methods: Medicare Part B National Summary Data Files for calendar years 2000 through 2014 were used to identify the number of services billed by assistant and primary surgeons for vitreoretinal surgeries. The proportion of procedures involving an assistant was determined for each year. Linear regression analysis was performed to identify trends in use.

Main outcome measure: Percentage of vitreoretinal procedures using an assistant surgeon.

Results: From 2000 through 2014, 12% of eligible vitreoretinal surgeries (216 637/1 808 377) involved a surgical assistant. In 2000, 14% (13 115/94 742) of vitreoretinal surgeries used a surgical assistant compared with 10% in 2014 (13 360/136 945). In this 15-year period, there was a statistically significant decline in the proportion of vitreoretinal procedures using an assistant (P < 0.01).

Conclusions: From 2000 through 2014, surgical assistants were used in 12% of vitreoretinal surgeries. The percentage of cases using an assistant declined from 14% in 2000 to 10% in 2014 (P < 0.01), a 29% decline. This decline may be secondary to technological advances in vitrectomy, which confer greater surgeon independence, and a marked decline in scleral buckling procedures.