title: Trabeculectomy Outcomes by Supervised Trainees in a Veterans Affairs Medical Center.
abstract: To evaluate the outcomes of trabeculectomy performed in an ophthalmology training program.
  
  
  
  Retrospective study.
  
  
  
  A total of 160 patients undergoing trabeculectomy performed by a resident or fellow under attending supervision.
  
  
  
  Trabeculectomy surgeries performed by a supervised resident or fellow surgeon between October 2000 and April 2010 were reviewed. Success was considered to be complete or partial if intraocular pressure (IOP)-lowering medications were not or were required to achieve IOP≤21 mm Hg, respectively. Failure was defined as IOP>21 mm Hg on 2 consecutive visits, loss of light perception vision, IOP≤5 on 2 consecutive visits with associated visual acuity loss of ≥2 lines, or need for surgical intervention. Trabeculectomy survival was determined using Kaplan-Meier analysis through 60 months of follow-up.
  
  
  
  Final IOP, success/failure rate.
  
  
  
  Complete success was achieved in 65 patients (41%). The average final IOP of this group was 9.1±3.7 mm Hg. Qualified success was achieved in 56 patients (35%). The average final IOP of this group was 11.5±6.4 mm Hg. At 60 months, the estimated cumulative probability of survival for complete and qualified successes was 28.9% and 63.7%, respectively.
  
  
  
  Among patients undergoing trabeculectomy by supervised residents or glaucoma fellows in a large Veterans Affairs Medical Center, IOP reduction was significant and similar to published studies. Trabeculectomy remains a successful intervention to lower IOP, with satisfactory success rates in the hands of trainee surgeons.
authors.affiliation: Department of Ophthalmology, Baylor College of Medicine, Houston, TX.
authors.forename: Kristin S
authors.initials: KS
authors.lastname: Biggerstaff
authors.forename: Ryan D
authors.initials: RD
authors.lastname: Vincent
authors.forename: Albert P
authors.initials: AP
authors.lastname: Lin
authors.forename: Silvia
authors.initials: S
authors.lastname: Orengo-Nania
authors.forename: Benjamin J
authors.initials: BJ
authors.lastname: Frankfort
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002983:Clinical Competence / Q000592:standards; D005260:Female; D005901:Glaucoma / Q000601:surgery*; D006787:Hospitals, Veterans / Q000706:statistics & numerical data; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D007429:Intraocular Pressure / Q000502:physiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008505:Medical Staff, Hospital / Q000592:standards*; D008875:Middle Aged; D012189:Retrospective Studies; D014130:Trabeculectomy / Q000193:education / Q000379:methods / Q000592:standards