Purpose

To determine the efficacy, safety, and surgical outcomes of trabecular microbypass stent (iStent) surgery performed by resident trainees and attending surgeons.

Setting

Wills Eye Hospital, Philadelphia, Pennsylvania, USA.

Design

Retrospective case series.

Methods

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.

Results

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 16.2 months ± 17.9 (SD). The mean intraocular pressure (IOP) decreased from 16.0 ± 4.6 mm Hg at baseline to 14.0 ± 3.1 mm Hg at most recent follow-up visit in the resident group (P = .02) and from 17.5 ± 4.8 mm Hg to 15.1 ± 4.3 mm 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.

Conclusion

Microbypass stent implantation by resident trainees with attending supervision had similar efficacy and safety as surgery performed by attending surgeons.

中文翻译：

---

小梁微旁路手术的效果：住院医师与主治医师的比较

目的

确定住院医师和主治外科医生进行小梁微旁路支架术（iStent）的疗效，安全性和手术效果。

设置

美国宾夕法尼亚州费城的威尔斯眼科医院。

设计

回顾案例系列。

方法

回顾性地回顾了威尔斯眼科医院一名住院医师进行过微旁路支架手术的患者的记录。参加执行的组包括在住院病人当天由主治医生植入微型旁路支架的任何患者。

结果

在2016年至2018年之间，住院医师在住院病人当天进行了31例微型旁路支架植入，并由主治医师植入了93例微型旁路支架。平均随访时间为16.2个月±17.9（标准差）。平均眼压（IOP）从基线时的16.0±4.6 mm Hg降低到住院组最近一次随访时的14.0±3.1 mm Hg（P  = .02），从17.5±4.8 mm Hg降低至15.1±4.3毫米汞柱，分别在参加小组（P  <.001）。两组的最终平均眼压和降压药物的平均数量相似（P  = .83和P 分别为.12）。自我解决的前房积血发生在1例常住病例和2例主治病例中。常驻组有1例虹膜透析患者，不需要其他手术。参加组中的一只眼睛最终需要进行小梁切除术。

结论

由住院医师在主治医师的陪同下进行Microbypass支架植入术的效果和安全性与主治医师的手术相似。