Can trainees perform Ahmed glaucoma valve surgery as effectively as attendings?

Area of Science:

• Ophthalmology
• Glaucoma Surgery
• Surgical Education

Background:

• Glaucoma is a leading cause of irreversible blindness worldwide.
• Ahmed glaucoma valve (AGV) implantation is a surgical option for refractory glaucoma.
• Evaluating resident surgical performance is crucial for quality patient care and training.

Purpose of the Study:

• To compare surgical outcomes and early postoperative complications of AGV implantation performed by residents versus attending physicians.
• To assess the safety and efficacy of resident-led glaucoma surgery.

Main Methods:

• Retrospective, case-control study.
• Chart review of consecutive AGV model FP7 implantations (January 2014 - July 2017).
• Comparison of 1-year postoperative outcomes in 144 patients (72 resident, 72 attending).

Main Results:

• No significant difference in mean intraocular pressure (IOP) reduction between resident and attending groups.
• Significantly higher rates of hyphema and shallow anterior chamber in the resident group (P=0.001, P=0.04).
• Neovascular glaucoma (NVG) was more prevalent in the resident group (30.6% vs. 1.4%, P < 0.001).

Conclusions:

• Resident-performed AGV surgery effectively lowers IOP, comparable to attending surgeons.
• Increased complication rates in the resident group may be attributed to a higher incidence of NVG.
• Further supervision and training may be needed to mitigate complications in resident-performed AGV surgery.