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Unplanned Return to the Operating Room After Trabeculectomy.

Nur Cardakli1, David S Friedman2, Michael V Boland1

  • 1Glaucoma Center of Excellence, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

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Trabeculectomy surgery has a nearly 10% unplanned return to the operating room (OR) rate within 180 days and over 20% reoperation rate long-term. These rates highlight the need for further evaluation of surgical quality in ophthalmology.

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Area of Science:

  • Ophthalmology
  • Surgical Quality Assessment

Background:

  • Trabeculectomy is a common glaucoma surgery.
  • Unplanned returns to the operating room (OR) can indicate complications or suboptimal outcomes.

Purpose of the Study:

  • To determine the rate of unplanned return to the operating room (OR) within 180 days and at any time post-trabeculectomy.
  • To identify factors associated with these returns.

Main Methods:

  • Retrospective case-control study of 881 eyes undergoing trabeculectomy.
  • Inclusion criteria: adult patients, >180 days follow-up, no prior glaucoma surgery in the last year.
  • Time-matched controls were used for reoperated eyes.

Main Results:

  • The reoperation rate was 9.5% within 180 days and 23.3% at any time postoperatively.
  • Excluding intraoperative bleb needling, rates were 6.5% (180 days) and 13.6% (any time).
  • Common reoperations included bleb revision and needling; tube shunt implantation was also noted.

Conclusions:

  • Nearly 10% of eyes returned to the OR within 180 days, and over 20% required reoperation long-term.
  • Unplanned return to OR warrants consideration as a surgical quality metric in ophthalmology.