Trabeculectomy: a training dilemma

Abstract

Aim/Purpose The incidence of trabeculectomy is falling due to more effective medical therapies, resulting in fewer trabeculectomy operations carried out by Ophthalmology trainees. This study audits all primary trabeculectomy procedures performed publicly at the two major teaching hospitals in Brisbane, Australia. Method A retrospective consecutive case review analysing the rates and outcomes of Ophthalmology trainee versus consultant trabeculectomies that were performed during the period May 1996-May 2002. Results In all, 290 primary trabeculectomies were undertaken during the study period. Ophthalmology trainees performed 95 (33%) of the procedures. This represents a rate of 1.6 trabeculectomy procedures per year per trainee (10 trainees train at the two hospitals per year). Rates of complications postoperatively were similar between the trainee and consultant groups. The percentage of patients achieving an IOP p15 mmHg on no medication at their last follow-up was low at 30%. Conclusions The results of this study suggests that improvement in trabeculectomy technique is required. In order to acquire skills, wetlab training on artificial or animal eyes may become mandatory within the training programmes, otherwise trabeculectomy will become the realm of subspecialists with glaucoma fellowship training.

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

“…17 In our study, consultants operated on significantly more cases of complicated glaucoma and those who had undergone previous ocular surgery. The only significant difference in IOP control was found at postoperative visit 1 month in trainee cases of pseudoexfoliation and lowtension glaucoma, in which IOP was significantly higher compared with consultant cases.…”

Subconjunctival Air Leakage After Descemet's Stripping Automated Endothelial Keratoplasty(DSAEK) in a Post-Trabeculectomy Eye

“…Even without any pressure from subconjunctival air, early- and late-onset bleb leak and its associated hypotony are among the most common complications after trabeculectomy [5, 6]. …”

Response to Drs Vani and Delvin

“…City Eye Centre, Brisbane, Queensland, Australia E-mail: eye@cityeye.com.au Sir, Awareness and the use of nutritional supplementation for age-related macular degeneration patients We read with interest the article 'Awareness and the use of nutritional supplementation for age-related macular degeneration (AMD) patients' by Waisbourd et al 1 The authors reported that their 'AMD patients lack knowledge about their own ocular disease.' The authors, however, erroneously stated that 'other studies conducted internationally demonstrated lack of awareness for this blinding disease among the general population with 9.2-30% who were not familiar with the disease.'…”