Evaluating surgical experience in trabeculectomy: Insights from a single-surgeon learning curve

PurposeThe aim of our study was to evaluate the outcome of trabeculectomy with respect to surgeon's experience and to explore additional contributing factors.MethodsThis retrospective study was conducted analyzing consecutive single-surgeon cases from October 2019 to June 2022 receiving TE with mitomycin C. Eyes were categorized into five groups based on surgeon experience: E1 for the first 50 TEs, E2 for 51-100, E3 for 101-150, E4 for 151-200, E5 for 201-300. Complete success at one year was defined as an IOP <18 mmHg and 20%-IOP reduction without glaucoma eye drops and revision surgeries.Results300 eyes were included (mean age 68.8 ± 13.0 years, 58.3% female). 55.7% had primary open-angle glaucoma. The baseline IOP was 23.4 ± 8.7 mmHg with 3.0 ± 0.9 different antiglaucomatous medication. After 12 months, the complete success for E1 to E5, it was 83.0%, 86.7%, 87.4%, 75.3% and 79.1% (p < 0.0001) with IOP 12.8 ± 6.1, 12.8 ± 6.3, 11.5 ± 4.6, 12.9 ± 6.5, 12.9 ± 4.7 mmHg while there was a higher number of NTG cases in E4 and E5 (p = 0.04).ConclusionsEven a novice surgeon can achieve a good surgical outcome within the first 50 trabeculectomy under the guidance of an experienced surgeon. When comparing surgical results over time, it is important to incorporate case entity and severity.