Glaucoma surgery: trainee outcomes and implications for future training: southeast Scotland

Welch, Julia D; Vani, A; Cackett, Peter; Vallance, J; Cobb, Caroline; Devlin, H; Sanders, Roshini

doi:10.1038/eye.2010.135

Cited by 17 publications

(31 citation statements)

References 20 publications

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“…Over the 2 year period the trainee group had a statistically significant higher complication rate, with bleb leaks and hypotony being the most frequent complications. This chimes with the findings of Welch et al who have shown previously that trainee trabeculectomies have higher return to theatre rates associated with bleb leaks [7]. Interestingly in their subgroup analysis of the MMC trabeculectomies they also found trainee cases had significantly higher return to theatre rates.…”

Section: Discussionsupporting

confidence: 88%

Trabeculectomy training in England: are we safe at training? Two year surgical outcomes

Walkden

Huxtable

Senior

et al. 2018

Eye

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The outcomes of supervised trainee trabeculectomy compare favourably with consultant cases after 2 year follow up. Trainee cases had higher complication rates than consultant cases. Bleb leaks are a common complication of trainee cases, where closer supervision may be required. There is potential for surgical simulation to help increase the success of such cases. These findings may encourage trainee participation in glaucoma surgery.

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Section: Discussionsupporting

confidence: 88%

Trabeculectomy training in England: are we safe at training? Two year surgical outcomes

Walkden

Huxtable

Senior

et al. 2018

Eye

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“…Resident performed glaucoma surgery has been addressed by several studies and found to be similar in IOP lowering and overall success rates long term when compared with faculty or attending surgery. [11][12][13][14] Most of these studies compared and found similar complication rates as well, although 1 study did report higher complication rates in trainee performed cases. 11 Our results suggest that trainee performed surgery has similar success and complication rates to the published literature.…”

Section: Discussionmentioning

confidence: 89%

“…[11][12][13][14] Most of these studies compared and found similar complication rates as well, although 1 study did report higher complication rates in trainee performed cases. 11 Our results suggest that trainee performed surgery has similar success and complication rates to the published literature. 21 This makes it impossible to choose a definition of success that makes comparison across all studies valid.…”

Section: Discussionmentioning

confidence: 89%

“…Our criteria of qualified success is similar to standards used in multiple manuscripts, and our results are comparable to rates published in various other series in the literature, which ranged from 62.4% to 89.7%. 7,[11][12][16][17][18][19][20] Four of these studies reported results from resident-performed cases as well, although only one of the resident series came from the United States. [11][12][19][20] Two of these studies had a significantly shorter follow-up period of 1 year, 19,20 compared with the mean follow-up of 31.2 months in this series.…”

Section: Discussionmentioning

confidence: 92%

“…Accordingly, several studies have looked at complication and failure rates of resident performed trabeculectomy when compared with glaucoma specialists. [11][12][13][14] Some data support higher complication rates and more frequent returns to the operating room in resident performed trabeculectomy, but most reports in the literature demonstrate comparable outcomes between consultant specialist and trainee cases, suggesting that trabeculectomy remains a safe and effective surgery to incorporate into resident training. [12][13][14] This study represents a summary of our experience with trabeculectomy surgery in the setting of an ophthalmology training program in a large Veterans Affairs Medical Center.…”

mentioning

confidence: 99%

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Trabeculectomy Outcomes by Supervised Trainees in a Veterans Affairs Medical Center

Biggerstaff

Vincent

Lin

et al. 2016

Journal of Glaucoma

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A Proposed Minimum Standard Set of Outcome Measures for Cataract Surgery

Mahmud¹,

Kelley²,

Stowell³

et al. 2015

JAMA Ophthalmol

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IMPORTANCE Aligning outcome measures for cataract surgery, one of the most frequently performed procedures globally, may facilitate international comparisons that can drive improvements in the outcomes most meaningful to patients. OBJECTIVE To propose a minimum standard set of outcome measures for cataract surgery that enables global comparisons. DESIGN, SETTING, AND PARTICIPANTS A working group of international experts in cataract outcomes and registries was convened, along with a patient advocate, to agree on a consensus of outcome measures for cataract surgery. In a modified Delphi process, the group met regularly between November 10, 2012, and November 21, 2013, to discuss which outcomes to include in a standard set. Included factors were based on extant literature, existing registries, and the experience of group members. Similarly, a series of consensus discussions were held to determine a set of risk factors to be gathered for each patient. The final shortlist was compiled into a standard set. Analysis was performed from November 22, 2013, to April 5, 2014. MAIN OUTCOMES AND MEASURES Development of a recommended standard set encompassing preoperative metrics including patient risk factors, intraoperative factors including surgical complications, and postoperative cataract surgery outcomes. RESULTS The recommended standard set encompasses all patients treated for cataracts by 1 of 4 surgical approaches (phacoemulsification, sutured manual extracapsular cataract extraction, sutureless manual extracapsular cataract extraction, or intracapsular cataract extraction). The recommended metrics to be recorded preoperatively include demographics, ocular history and comorbidities, preoperative visual acuity, and patient-reported visual function. The recommended outcomes were split into intraoperative and postoperative metrics. Intraoperative outcomes include capsule-related problems, dislocation of lens nucleus fragments into the vitreous, and other complications. Postoperative outcomes include visual acuity, refractive error, patient-reported visual function, and early and late complications of surgery. The suggested follow-up for collection of postoperative outcomes is up to 3 months. CONCLUSIONS AND RELEVANCE A minimum standard set of outcome measures for cataract surgery is important for meaningful comparison across contexts. The proposed data set is a compromise between all useful data and the practicalities of data collection.

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Glaucoma surgery: trainee outcomes and implications for future training: southeast Scotland

Cited by 17 publications

References 20 publications

Trabeculectomy training in England: are we safe at training? Two year surgical outcomes

Trabeculectomy training in England: are we safe at training? Two year surgical outcomes

Trabeculectomy Outcomes by Supervised Trainees in a Veterans Affairs Medical Center

A Proposed Minimum Standard Set of Outcome Measures for Cataract Surgery

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