Abstract
Purpose :
A variety of literature exists assessing the safety and efficacy of resident-performed laser and traditional glaucoma surgery. In contrast, there is no available literature studying outcomes of resident-performed microinvasive glaucoma surgery (MIGS) due to the novelty of these surgeries. The purpose of our study is to observe the effectiveness and safety of resident performed GATT. Herein, we describe a single surgeon’s experience teaching residents GATT.
Methods :
Retrospective chart review of patients undergoing resident-performed GATT at an academic medical center from 12/18/19 to 9/30/2021. A resident must have performed more than 50% of the GATT. Patients required at least 90 days of follow-up for inclusion in IOP analysis. Cases of NVG were excluded.
Results :
There were 49 eyes from 40 patients (24 POAG, 9 mixed mechanism, 6 chronic angle closure, 5 steroid induced, 2 low tension, 1 trauma, 1 pigmentary, and 1 secondary glaucoma due to ghost cell). Phaco-GATT was performed on 40 eyes. GATT-alone was performed on 9 eyes. Mean follow-up for phaco-GATT was 251 days (range 27-579), and for GATT alone was 369 days (range 48-643). In the phaco-GATT group, 35/40 reached follow-up >90 days. In the GATT alone group, 8/9 eyes reached follow-up >90 days. Both mean IOP and mean number of medications were reduced from baseline at 3, 6, and 12 months postoperatively in both surgical groups (except for mean medications at 12 months in the GATT-alone group), however some timepoints did not reach statistical significance, likely due to small sample size. Complications included 5 hyphemas at postoperative week one (12%), 2 hyphemas at postoperative month one (6%) (all hyphemas <0.5mm in height), 1 Descemet’s detachment that resolved with air bubble (2%), 1 choroidal effusion (2%), and 1 cystoid macular edema (2%). GATT-alone took an average of 39 minutes (range 23-77 minutes). Phaco-GATT took an average of 67 minutes (range 31-156 minutes).
Conclusions :
GATT is being performed more readily both in the community and at academic centers. As such, physicians in training will be learning how to perform this surgery more readily. Our study has shown that trainees have a similar success and complication rate to that reported in the literature, although operating times may be longer than expected for attending-performed cases.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.