Weekend effect on vitrectomy: Insights from a Nationwide Population-Based Study in Korea

PURPOSE: To compare the reoperation rate of vitrectomy between weekend/holiday and weekday surgeries. METHODS: This nationwide, population-based retrospective cohort study used the Korean Health Insurance Review and Assessment Service database to identify 387,544 adults (≥18 years) who underwent initial vitrectomy between January 2011 and March 2024. Weekend/holiday and weekday surgeries were compared. The risk of reoperation within 90 days was assessed using Cox proportional hazards regression, with sensitivity analyses extending the outcome to 180 days and subgroup analyses of the five most common diagnoses. Logistic regression was performed as a secondary analysis. RESULTS: 45,074 patients underwent vitrectomy on weekends/holidays and 342,470 on weekdays. Reoperation rates per 100 person-months were 2.83 in the weekend/holiday group and 2.87 in the weekday group. Weekend/holiday surgery was not associated with reoperation within 90 days (aHR, 1.00; 95% CI, 0.97-1.04; P = 0.860) or 180 days (aHR, 1.02; 95% CI, 0.99-1.04; P = 0.274). Logistic regression showed consistent results for both 90 days (aOR, 1.00; 95% CI, 0.97-1.04; P = 0.849) and 180 days (aOR, 1.02; 95% CI, 0.99-1.05; P = 0.283). Subgroup analyses revealed no association between weekend/holiday surgery and reoperation across diagnostic categories, except for vitreous hemorrhage, in which a higher risk of reoperation was observed within 180 days (aHR, 1.09; 95% CI, 1.02-1.16; P = 0.011; aOR, 1.10; 95% CI, 1.02-1.18; P = 0.009). CONCLUSION: Our analysis of nationwide claims data from Korea demonstrated that vitrectomy surgery is not subject to a weekend effect, either overall or within major diagnostic subgroups.