Five-Year Treatment Outcomes of Resident-Performed Ahmed Valve Implantation for Glaucoma.

Abstract

Prcis: Ahmed glaucoma valve implantation by residents showed similar complications, success, and failure rates, regardless of their level of expertise. Training programs must encourage ophthalmologists to perform this surgery to enhance competence in their future practices.

Purpose: To describe outcomes of resident-performed Ahmed valve implantation over a 5-year period.

Methods: In this cross-sectional observational study we retrospectively reviewed the medical records of patients who underwent resident-performed Ahmed glaucoma valve implantation over a 5-year period. The main outcomes were the number of surgeries performed by first-year, second-year, and third-year residents, intraoperative, and postoperative complications, and the association of level of training with outcomes and complications.

Results: Totally, 160 eyes were included, with a mean age of 53.8±15.4 years, 63% were men. The most frequent type of glaucoma was neovascular glaucoma (67.5%). Mean follow-up was 23.2±19.6 months. Residents of higher years performed more surgeries and no relationship was found between the surgeon's level of training and type of glaucoma operated on. After the surgical procedure, significant changes in best-corrected visual acuity were noted in surgeries performed by third-year residents ( P =0.04). Intraocular pressure and number of medications were significantly reduced in all groups ( P =0.01). Complications were registered in 60 eyes; the most frequent being the presence of a transient flat anterior chamber (27.45%).

Conclusions: There were no significant differences in terms of IOP control and the number of complications in the 3 groups. There was no significant association between the resident's experience and the outcomes of the surgery. The Ahmed valve implant is a procedure that appears to have similar results in surgeons with different levels of training.