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Survey of glaucoma surgical preferences and post‐operative care in the United Kingdom
Author(s) -
RodriguezUna Ignacio,
AzuaraBlanco Augusto,
King Anthony J
Publication year - 2017
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/ceo.12846
Subject(s) - medicine , trabeculectomy , glaucoma , glaucoma surgery , intraocular pressure , ophthalmology , surgery , open angle glaucoma , optometry , general surgery
Abstract Background To evaluate the spectrum of glaucoma surgery and the post‐operative follow‐up regimes undertaken among glaucoma specialists in the United Kingdom. Design National survey. Participants Seventy‐five glaucoma specialists (consultants and fellows). Methods An eight‐question survey was emailed to all glaucoma subspecialists members of the United Kingdom and Eire Glaucoma Society. Main Outcome Measures Surgery undertaken, post‐operative management, awareness of intervention tariff and handling of the follow‐up burden generated through surgery. Results Almost all the participants (74/75: 99%) routinely performed trabeculectomy, 54 responders (72%) undertook tube surgery and Minimally Invasive Glaucoma Surgery (MIGS) was more frequently undertaken (33.0%) than non‐penetrating surgery (23%). In general, for patients with advanced glaucoma requiring a low target intraocular pressure (IOP), the most frequent primary intervention was trabeculectomy (99%), followed by tubes (64%). Similarly, in patients with less advanced glaucoma requiring moderate target IOP, participants preferred trabeculectomy (99%), followed by MIGS (60%). By the first 6 months after the procedure, trabeculectomy and Baerveldt tube implant required a larger number of postoperative visits (9 and 7, respectively), than iStent® and non‐penetrating deep sclerectomy (3 and 5, respectively). The majority of participants were not aware of the costs of their interventions. Conclusions A wide variety of glaucoma surgery techniques are undertaken. Post‐operative follow‐up regimes are variable between techniques and for surgeons using the same technique. Trabeculectomy requires more follow‐up than any other intervention. For patients requiring low IOP, trabeculectomy is the operation of choice for most surgeons.