Trabeculectomy: the limitations for registrar training

Sun, Lisa L. and Lee, Graham A. (2013) Trabeculectomy: the limitations for registrar training. Clinical and Experimental Ophthalmology, 41 2: 135-139. doi:10.1111/j.1442-9071.2012.02831.x


Author Sun, Lisa L.
Lee, Graham A.
Title Trabeculectomy: the limitations for registrar training
Journal name Clinical and Experimental Ophthalmology   Check publisher's open access policy
ISSN 1442-6404
1442-9071
Publication date 2013-03
Year available 2012
Sub-type Article (original research)
DOI 10.1111/j.1442-9071.2012.02831.x
Volume 41
Issue 2
Start page 135
End page 139
Total pages 5
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing
Collection year 2014
Language eng
Formatted abstract
Background:  Trainee exposure to glaucoma surgery was analysed and outcomes compared with those of consultant cases.
Design:  Retrospective review was carried out at Princess Alexandra Hospital and Royal Brisbane and Women's Hospital, two major tertiary teaching hospitals in Brisbane, Queensland, Australia.
Participants:  Two hundred and forty-eight consecutive public patients undergoing primary trabeculectomy surgery between 2003 and 2010.
Methods:  The rate of trabeculectomy performed by trainees, the success and complication rates were examined and compared with those of consultant ophthalmologists.
Main Outcome Measures:  Intraocular pressure was divided into two groups of ≤21 mmHg and ≤15 mmHg and visual field progression.
Results:  Two hundred and forty-eight primary trabeculectomy cases were performed between 2003 and 2010. Trainees carried out 145 cases (59%), making the rate of trabeculectomy operations 1.1 per trainee per year (16–17 trainees) as compared with 1.6 per trainee per year from 1996 to 2002 at the same institutions. Complications rates in the first postoperative week were similar between consultants and trainees, the most common being wound leak and hyphaema. An intraocular pressure of ≤15 mmHg without the use of topical medications was achieved in 25 out of 50 (50%) glaucoma interest consultant, 24 out of 53 (45.3%) general consultant and 68 out of 145 (46.9%) trainee cases (P = 0.951). The rate of visual field progression was also statistically similar between trainees and consultants (19.5% and 21.3%), respectively.
Conclusion:  With increasing trainee numbers, the rate of trabeculectomy surgery is declining compared with previous years, with less trainee exposure to trabeculectomy surgery and inability to achieve surgical competency levels.
Keyword Glaucoma
Surgery
Trabeculectomy
Training
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online 21 August 2012

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Medicine Publications
 
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