The national survey of trabeculectomy. II. Variations in operative technique and outcome

Lorna (Beth) Edmunds, J. R. Thompson, J. F. Salmon, R. P. Wormald

Research output: Contribution to journalArticle

73 Citations (Scopus)

Abstract

Purpose. There is a considerable body of literature relating to trabeculectomy; however, there are no data representative of the national experience of trabeculectomy in the United Kingdom (UK). The Department of Health funded a national survey of trabeculectomy to establish current practice patterns and the outcome of trabeculectomy in the National Health Service (NHS). In this paper we report variations in surgical technique and the national success rate of trabeculectomy. Methods. A cross-sectional survey was carried out of consultant ophthalmologists performing trabeculectomy in the NHS. Participants recruited their four most recent consecutive first-time trabeculectomy cases according to study eligibility criteria and data were collected by self-administered questionnaire. Follow-up: 1 year posttrabeculectomy. Main outcome measure of success: final intraocular pressure (IOP) less than two-thirds the pre-operative IOP. Secondary outcome measures of success: final IOP less than 21 mmHg and visual field stability. Success was further defined as unqualified (excluding patients on antiglaucoma medications at final follow-up) or qualified (including patients on anti-glaucoma medications at final follow-up). The relationship between variables characterising consultants' practice and main outcome measure was examined by chi-square test. Results. Clinical outcome data were available for 1240 (85.3%) cases. There were wide variations in operative technique. The mean post-operative IOP was 14.4 mmHg (95% CI 14.2-14.7), which is a mean reduction of 11.8 mmHg (95% CI 11.4-12.2). An unqualified success, in terms of the main outcome measure, was achieved in 66.6% of patients and a qualified success in 71.0% of cases. An unqualified success, in terms of a final IOP less than 21 mmHg, was achieved in 84.0% of cases and a qualified success in 92.0%. Visual fields were stable in 84.2%. Outcome was not related to consultants' specialist interest, level of activity, type of hospital or region. Conclusions. The success rates reported in this paper represent the national experience of first-time trabeculectomy for open angle glaucoma in the UK. The national success rate at 1 year compares favourably with many studies in the literature. This survey provides valid and clinically relevant measures of success for the production of guidelines and standards for audit at regional, local and individual level and a baseline for the comparison of new therapies.

Original languageEnglish (US)
Pages (from-to)441-448
Number of pages8
JournalEye
Volume15
Issue number4
StatePublished - 2001
Externally publishedYes

Fingerprint

Trabeculectomy
Intraocular Pressure
Consultants
Outcome Assessment (Health Care)
National Health Programs
Visual Fields
Surveys and Questionnaires
Open Angle Glaucoma
Chi-Square Distribution
Glaucoma
Cross-Sectional Studies
Guidelines
Health

Keywords

  • Intraocular pressure
  • National survey
  • Outcomes
  • Trabeculectomy

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems

Cite this

Edmunds, L. B., Thompson, J. R., Salmon, J. F., & Wormald, R. P. (2001). The national survey of trabeculectomy. II. Variations in operative technique and outcome. Eye, 15(4), 441-448.

The national survey of trabeculectomy. II. Variations in operative technique and outcome. / Edmunds, Lorna (Beth); Thompson, J. R.; Salmon, J. F.; Wormald, R. P.

In: Eye, Vol. 15, No. 4, 2001, p. 441-448.

Research output: Contribution to journalArticle

Edmunds, LB, Thompson, JR, Salmon, JF & Wormald, RP 2001, 'The national survey of trabeculectomy. II. Variations in operative technique and outcome', Eye, vol. 15, no. 4, pp. 441-448.
Edmunds, Lorna (Beth) ; Thompson, J. R. ; Salmon, J. F. ; Wormald, R. P. / The national survey of trabeculectomy. II. Variations in operative technique and outcome. In: Eye. 2001 ; Vol. 15, No. 4. pp. 441-448.
@article{dfef1d3051e44bfaa9ef57b07350c338,
title = "The national survey of trabeculectomy. II. Variations in operative technique and outcome",
abstract = "Purpose. There is a considerable body of literature relating to trabeculectomy; however, there are no data representative of the national experience of trabeculectomy in the United Kingdom (UK). The Department of Health funded a national survey of trabeculectomy to establish current practice patterns and the outcome of trabeculectomy in the National Health Service (NHS). In this paper we report variations in surgical technique and the national success rate of trabeculectomy. Methods. A cross-sectional survey was carried out of consultant ophthalmologists performing trabeculectomy in the NHS. Participants recruited their four most recent consecutive first-time trabeculectomy cases according to study eligibility criteria and data were collected by self-administered questionnaire. Follow-up: 1 year posttrabeculectomy. Main outcome measure of success: final intraocular pressure (IOP) less than two-thirds the pre-operative IOP. Secondary outcome measures of success: final IOP less than 21 mmHg and visual field stability. Success was further defined as unqualified (excluding patients on antiglaucoma medications at final follow-up) or qualified (including patients on anti-glaucoma medications at final follow-up). The relationship between variables characterising consultants' practice and main outcome measure was examined by chi-square test. Results. Clinical outcome data were available for 1240 (85.3{\%}) cases. There were wide variations in operative technique. The mean post-operative IOP was 14.4 mmHg (95{\%} CI 14.2-14.7), which is a mean reduction of 11.8 mmHg (95{\%} CI 11.4-12.2). An unqualified success, in terms of the main outcome measure, was achieved in 66.6{\%} of patients and a qualified success in 71.0{\%} of cases. An unqualified success, in terms of a final IOP less than 21 mmHg, was achieved in 84.0{\%} of cases and a qualified success in 92.0{\%}. Visual fields were stable in 84.2{\%}. Outcome was not related to consultants' specialist interest, level of activity, type of hospital or region. Conclusions. The success rates reported in this paper represent the national experience of first-time trabeculectomy for open angle glaucoma in the UK. The national success rate at 1 year compares favourably with many studies in the literature. This survey provides valid and clinically relevant measures of success for the production of guidelines and standards for audit at regional, local and individual level and a baseline for the comparison of new therapies.",
keywords = "Intraocular pressure, National survey, Outcomes, Trabeculectomy",
author = "Edmunds, {Lorna (Beth)} and Thompson, {J. R.} and Salmon, {J. F.} and Wormald, {R. P.}",
year = "2001",
language = "English (US)",
volume = "15",
pages = "441--448",
journal = "Eye (Basingstoke)",
issn = "0950-222X",
publisher = "Nature Publishing Group",
number = "4",

}

TY - JOUR

T1 - The national survey of trabeculectomy. II. Variations in operative technique and outcome

AU - Edmunds, Lorna (Beth)

AU - Thompson, J. R.

AU - Salmon, J. F.

AU - Wormald, R. P.

PY - 2001

Y1 - 2001

N2 - Purpose. There is a considerable body of literature relating to trabeculectomy; however, there are no data representative of the national experience of trabeculectomy in the United Kingdom (UK). The Department of Health funded a national survey of trabeculectomy to establish current practice patterns and the outcome of trabeculectomy in the National Health Service (NHS). In this paper we report variations in surgical technique and the national success rate of trabeculectomy. Methods. A cross-sectional survey was carried out of consultant ophthalmologists performing trabeculectomy in the NHS. Participants recruited their four most recent consecutive first-time trabeculectomy cases according to study eligibility criteria and data were collected by self-administered questionnaire. Follow-up: 1 year posttrabeculectomy. Main outcome measure of success: final intraocular pressure (IOP) less than two-thirds the pre-operative IOP. Secondary outcome measures of success: final IOP less than 21 mmHg and visual field stability. Success was further defined as unqualified (excluding patients on antiglaucoma medications at final follow-up) or qualified (including patients on anti-glaucoma medications at final follow-up). The relationship between variables characterising consultants' practice and main outcome measure was examined by chi-square test. Results. Clinical outcome data were available for 1240 (85.3%) cases. There were wide variations in operative technique. The mean post-operative IOP was 14.4 mmHg (95% CI 14.2-14.7), which is a mean reduction of 11.8 mmHg (95% CI 11.4-12.2). An unqualified success, in terms of the main outcome measure, was achieved in 66.6% of patients and a qualified success in 71.0% of cases. An unqualified success, in terms of a final IOP less than 21 mmHg, was achieved in 84.0% of cases and a qualified success in 92.0%. Visual fields were stable in 84.2%. Outcome was not related to consultants' specialist interest, level of activity, type of hospital or region. Conclusions. The success rates reported in this paper represent the national experience of first-time trabeculectomy for open angle glaucoma in the UK. The national success rate at 1 year compares favourably with many studies in the literature. This survey provides valid and clinically relevant measures of success for the production of guidelines and standards for audit at regional, local and individual level and a baseline for the comparison of new therapies.

AB - Purpose. There is a considerable body of literature relating to trabeculectomy; however, there are no data representative of the national experience of trabeculectomy in the United Kingdom (UK). The Department of Health funded a national survey of trabeculectomy to establish current practice patterns and the outcome of trabeculectomy in the National Health Service (NHS). In this paper we report variations in surgical technique and the national success rate of trabeculectomy. Methods. A cross-sectional survey was carried out of consultant ophthalmologists performing trabeculectomy in the NHS. Participants recruited their four most recent consecutive first-time trabeculectomy cases according to study eligibility criteria and data were collected by self-administered questionnaire. Follow-up: 1 year posttrabeculectomy. Main outcome measure of success: final intraocular pressure (IOP) less than two-thirds the pre-operative IOP. Secondary outcome measures of success: final IOP less than 21 mmHg and visual field stability. Success was further defined as unqualified (excluding patients on antiglaucoma medications at final follow-up) or qualified (including patients on anti-glaucoma medications at final follow-up). The relationship between variables characterising consultants' practice and main outcome measure was examined by chi-square test. Results. Clinical outcome data were available for 1240 (85.3%) cases. There were wide variations in operative technique. The mean post-operative IOP was 14.4 mmHg (95% CI 14.2-14.7), which is a mean reduction of 11.8 mmHg (95% CI 11.4-12.2). An unqualified success, in terms of the main outcome measure, was achieved in 66.6% of patients and a qualified success in 71.0% of cases. An unqualified success, in terms of a final IOP less than 21 mmHg, was achieved in 84.0% of cases and a qualified success in 92.0%. Visual fields were stable in 84.2%. Outcome was not related to consultants' specialist interest, level of activity, type of hospital or region. Conclusions. The success rates reported in this paper represent the national experience of first-time trabeculectomy for open angle glaucoma in the UK. The national success rate at 1 year compares favourably with many studies in the literature. This survey provides valid and clinically relevant measures of success for the production of guidelines and standards for audit at regional, local and individual level and a baseline for the comparison of new therapies.

KW - Intraocular pressure

KW - National survey

KW - Outcomes

KW - Trabeculectomy

UR - http://www.scopus.com/inward/record.url?scp=0034885115&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034885115&partnerID=8YFLogxK

M3 - Article

C2 - 11767016

AN - SCOPUS:0034885115

VL - 15

SP - 441

EP - 448

JO - Eye (Basingstoke)

JF - Eye (Basingstoke)

SN - 0950-222X

IS - 4

ER -