Early Reoperation Rate, Complication, and Outcomes in Resident-performed Glaucoma Surgery

Area of Science:

• Ophthalmology
• Surgical Innovation
• Patient Outcomes

Background:

• Glaucoma surgery is crucial for vision preservation.
• Evaluating resident-performed procedures is essential for training and patient safety.
• Understanding complication and reoperation rates informs surgical practice.

Purpose of the Study:

• To assess the reoperation rate and complications of resident-performed glaucoma surgeries.
• To analyze outcomes within 90 days post-surgery for trabeculectomy, Ex-PRESS shunt, and Ahmed glaucoma valve (AGV).

Main Methods:

• Retrospective review of 180 glaucoma filtering surgeries performed by residents (2002-2014).
• Exclusion of combined surgeries; focus on reoperations within 90 days.
• Evaluation of complications, reoperation rates, and 1-year clinical outcomes for reoperated patients.

Main Results:

• 180 cases included: 34 trabeculectomy, 85 Ex-PRESS, 61 AGV.
• Common complications: choroidal effusion (65.3%), hypotony (45.2%), wound leak (32.7%).
• Overall reoperation rate was 3.9% (7 cases), primarily for wound leak or tube issues; outcomes were favorable.

Conclusions:

• Third-year resident-performed glaucoma surgeries (trabeculectomy, Ex-PRESS, AGV) demonstrate acceptable reoperation and complication rates.
• Clinical outcomes for patients requiring reoperation were favorable, with significant intraocular pressure reduction.