Trabeculectomy training in need of improvement

Trabeculectomy is in danger of becoming a technique performed only by sub-specialists with glaucoma fellowship training unless it becomes a mandatory feature in training programmes, according to a report published online ahead of print in Eye.

Graham Lee and colleagues from The University of Queensland, The Royal Brisbane Hospital and the Brisbane North Eye Centre, Australia, conducted a retrospective, consecutive case review to analyse the rates and outcomes of trabeculectomies performed by ophthalmology trainees and consultants.

During the study period, 290 primary trabeculectomies were performed. Trainees performed 33% of procedures, representing a rate of 1.6 procedures per year per trainee. Rates of postoperative complications were similar between the trainees and the consultants, however, the percentage of patients achieving an IOP of 15 mmHg in the absence of medications at their last follow-up was low, at just 30%.

The researchers believe that improvements are required in the ophthalmic training programme in order that the appropriate skills are learned and maintained. They warn that, if this does not happen, trabeculectomies could become a procedure performed only by sub-specialist groups.