Outcomes of trabecular microbypass surgery: Comparison of resident trainees and attending surgeons

Abstract

To determine the efficacy, safety, and surgical outcomes of trabecular microbypass stent (iStent) surgery performed by resident trainees and attending surgeons. Wills Eye Hospital, Philadelphia, Pennsylvania, USA. Retrospective case series. Records of all patients who had microbypass stent surgery by a resident at Wills Eye Hospital were retrospectively reviewed. The attending-performed group included any patient who had a microbypass stent implanted by an attending surgeon on the same day a resident case was performed. Between 2016 and 2018, 31 microbypass stents were implanted by a resident supervised by an attending and 93 microbypass stents were implanted by an attending surgeon on the day a resident case was performed. The mean follow-up was 16.2months±17.9 (SD). The mean intraocular pressure (IOP) decreased from 16.0±4.6mm Hg at baseline to 14.0±3.1mm Hg at most recent follow-up visit in the resident group (P=.02) and from 17.5±4.8mm Hg to 15.1±4.3mm Hg, respectively, in the attending group (P<.001). The final mean IOP and mean number of hypotensive medications were similar between the 2 groups (P=.83 and P=.12, respectively). Self-resolving hyphema occurred in 1 resident case and 2 attending cases. The resident group had 1 case of iridodialysis, which did not require additional surgery. One eye in the attending group ultimately required a trabeculectomy. Microbypass stent implantation by resident trainees with attending supervision had similar efficacy and safety as surgery performed by attending surgeons.