DOES THE LEVEL OF TRAINING PLAY A ROLE IN PATIENT SELECTION AND OUTCOME PREDICTION OF GLAUCOMA PATIENTS UNDERGOING TRABECULECTOMY?
Published 2024 - 28th ESCRS Winter Meeting
Reference: P166 | Type: Submission | DOI: 10.82333/bmv5-5748
Authors: Abdelaziz Abdelaal 1 , Eman Dyab 2 , Hashem Abu Serhan* 3
1Department of Ophthalmology,Harvard Medical School,Boston,United States;Doheny Eye Institute,University of California,LA,United States;Tanta University Hospitals, Faculty of Medicine,Tanta University,Tanta,Egypt;Tanta Research Team,Tanta,Egypt, 2Department of Pharmaceutics, Faculty of Pharmacy,University of Tripoli,Tripoli,Libya, 3Department of Ophthalmology,Hamad Medical Corporation,Doha,Qatar;Tanta Research Team,Tanta,Egypt
Purpose
To investigate the effect of training level in patient selection and outcome prediction of glaucoma patients undergoing trabeculectomy
Setting
Knowing if the provided training for residents is deemed enough for optimum patient care
Methods
PubMed, Scopus, Web of Science, and Google Scholar were searched for studies reporting resident-performed versus attending-performed trabeculectomy in glaucoma patients. Primary outcomes included differences in patient selection. Secondary outcomes included differences in patient outcomes (IOP, success, failure, reintervention/reoperation, and complications). All analyses were conducted using STATA. Differences in outcomes between groups were calculated as crude mean difference (MD) for continuous outcomes and log odds ratio for dichotomous outcomes.
Results
Residents were significantly less likely to operate on complicated glaucoma compared to attendings [870 eyes, logOR=-0.64; 95% CI: -1.00: -0.28, I2=0%, P=0.063]. Resident-performed trabeculectomy was associated with a significantly lower risk of failure as compared to attending-performed trabeculectomy [logOR = -1.14; 95% CI: -1.55: -0.74]. Resident-performed surgeries were associated with a significantly higher risk of complications than attending-performed surgeries [logOR = 0.4; 95% CI: 0.08: 0.72, I2=0%, P=0.67] especially bleb leak [428 eyes, logOR = 0.92; 95% CI: 0.26: 1.58, I2=28.83%, P=0.24], postoperative hyphema [966 eyes, logOR = 0.76; 95% CI: 0.22: 1.30, I2=11.91%, P=0.33], ocular hypertension [290 eyes, logOR = 0.89; 95% CI: 0.31: 1.47], and wound leakage [620 eyes, logOR = 0.82; 95% CI: 0.25: 1.39, I2=49.92%, P=0.14].
Conclusion
Resident-performed trabeculectomies are associated with a lower risk of failure, and a higher risk of complications, especially bleb leak, postoperative hyphema, and ocular hypertension.