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Abstract #128138 Published in IGR 25-3
Evaluating surgical experience in trabeculectomy: Insights from a single-surgeon learning curve
Strzalkowska A; Strzalkowski P; Daniello L; Hoffmann EM; Pfeiffer N; Schuster AKEuropean Journal of Ophthalmology 2025; 0: 11206721251370056
PURPOSE: The aim of our study was to evaluate the outcome of trabeculectomy with respect to surgeon's experience and to explore additional contributing factors. METHODS: This 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. RESULTS: 300 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% ( < 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 ( = 0.04). CONCLUSIONS: Even 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.
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