Peer Review

A third factor operating against the buckle operation for primary detachment, beyond the lack of training and the limit of reimbursement for the time spent, is the absence of peer review. Preop-erative surgical rounds, where the surgical plan for retinal detachment was open for review, suggestion, criticism, and even censure, have disappeared; with 1-day surgery, there is not time for it. The surgeon admits his patient on the day of the operation with as much preparation as his schedule allowed, and, when the patient leaves the hospital later in the day with the eye filled with gas, there is no opportunity to evaluate the effort by his or her peers.

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