Trends in Glaucoma Fellowship Surgical Experience

Area of Science:

• Ophthalmology
• Surgical Training
• Glaucoma Surgery

Background:

• Fellowship training is crucial for developing surgical expertise in glaucoma.
• Trabeculectomy and tube shunts are traditional glaucoma surgeries, while MIGS represents newer approaches.
• Trends in surgical case exposure during fellowship may indicate future surgeon competency.

Purpose of the Study:

• To evaluate trends in fellow exposure to trabeculectomy, tube shunt, and minimally invasive glaucoma surgery (MIGS) procedures.
• To assess changes in the frequency of these glaucoma surgeries during fellowship training over an 11-year period.

Main Methods:

• Analysis of fellowship surgical logs from 2013 to 2024.
• Data sourced from the Association of University Professors of Ophthalmology (AUPO) Fellowship Compliance Committee.
• Quantification of trabeculectomy, tube shunt, and MIGS procedures performed by fellows.

Main Results:

• Trabeculectomy exposure decreased by 55.9% (r = -0.89, p = 0.0002).
• Tube shunt surgery exposure decreased by 7.3% (r = -0.80, p = 0.003).
• MIGS procedures showed a significant increase of 128.6% (r = +0.72, p = 0.02) from 2016 to 2024.

Conclusions:

• Declining trabeculectomy exposure raises concerns about fellow proficiency in this fundamental procedure.
• Reduced competency may impact access to care for specific glaucoma patient populations.
• Maintaining trabeculectomy proficiency is essential for comprehensive glaucoma patient management.