Trabeculectomy: a training dilemma

doi:doi:10.1038/sj.eye.6702159

Eye (2007) 21, 183–186. doi:10.1038/sj.eye.6702159; published online 2 December 2005

Trabeculectomy: a training dilemma

There were no competing interests by the authors in the production of this manuscript

R Troutbeck¹, G A Lee^1,2, P Sanfilippo³ and B Fleming¹

¹Royal Brisbane Hospital, Brisbane, Australia
²Department of Ophthalmology, University of Queensland, Brisbane, Australia
³Brisbane North Eye Centre, Brisbane, Australia

Correspondence: G Lee, City Eye Centre, 10/135 Wickham Tce, Brisbane, Qld 4000, Australia Tel: +61 7 3831 6888; Fax: +61 7 3831 6883; E-mail: eye@cityeye.com.au

Received 23 June 2005; Accepted 17 September 2005; Published online 2 December 2005.

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Abstract

Aim/Purpose

The incidence of trabeculectomy is falling due to more effective medical therapies, resulting in fewer trabeculectomy operations carried out by Ophthalmology trainees. This study audits all primary trabeculectomy procedures performed publicly at the two major teaching hospitals in Brisbane, Australia.

Method

A retrospective consecutive case review analysing the rates and outcomes of Ophthalmology trainee versus consultant trabeculectomies that were performed during the period May 1996–May 2002.

Results

In all, 290 primary trabeculectomies were undertaken during the study period. Ophthalmology trainees performed 95 (33%) of the procedures. This represents a rate of 1.6 trabeculectomy procedures per year per trainee (10 trainees train at the two hospitals per year). Rates of complications postoperatively were similar between the trainee and consultant groups. The percentage of patients achieving an IOP less than or equal to 15 mmHg on no medication at their last follow-up was low at 30%.

Conclusions

The results of this study suggests that improvement in trabeculectomy technique is required. In order to acquire skills, wetlab training on artificial or animal eyes may become mandatory within the training programmes, otherwise trabeculectomy will become the realm of sub-specialists with glaucoma fellowship training.