Citation

Raj A, Yousif A, Awad J, Elahi B (2018) Current Surgical Practice of Trabeculectomy in the United Kingdom (UK National Trabeculectomy Survey 2016). Int J Ophthalmol Clin Res 5:094. doi.org/10.23937/2378-346X/1410094

Copyright

© 2018 Raj A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

ORIGINAL ARTICLE | OPEN ACCESSDOI: 10.23937/2378-346X/1410094

Current Surgical Practice of Trabeculectomy in the United Kingdom (UK National Trabeculectomy Survey 2016)

Akash Raj*, Ateeq Yousif, John Awad and Babar Elahi

Department of Ophthalmology, Russells Hall Hospital, United Kingdom

Abstract

Objective/Purpose

To evaluate the current practice of trabeculectomy among the United Kingdom & Eire Glaucoma Society (UKEGS) members.

Design

Cross sectional survey of glaucoma specialists in the UK.

Subjects, Participants and/or Controls

Glaucoma specialists' members of the UK & Eire Glaucoma Society (UKEGS).

Methods, Intervention or Testing

A 32 question online survey using a survey monkey web link was sent to the UKEGS members. All non-responders and partial responders were sent a reminder to complete the survey.

Main Outcome Measures

Responses relating to the surgical & non-surgical aspects of trabeculectomy surgery.

Results

The response rate was 67.6% (142/210) and the vast majority of the respondents (88%) were glaucoma consultants. Eighty percent of the respondents performed >10 trabeculectomies per year and 70% performed primary trabeculectomy, majority of which (>2/3) only did this rarely & in cases of late presentation. Progressive visual field loss was the most common indication for trabeculectomy. Majority (48.39%) use sub-tenon's block without digital massage/weight/Honan's balloon. About 89% used antimetabolites of which 99% used Mitomycin C (MMC) and the majority (60%) use this just after conjunctival peritomy. Most (80%) use 0.2 mg/ml of MMC and 58% use this for 3 minutes. Majority (57%) used their own self modified Moorfield's safe surgery technique & 88% perform a PI during trabeculectomy whereas 12% don't (in pseudophakes, myopic and where patients are on anticoagulation). Most (56%) use an AC maintainer (1/3 of them always). Only 29% performed phaco trab' regularly (2/3rd used different sites), 44% never.

Conclusion

This survey highlights a varied spectrum in the practice of trabeculectomy. This may reflect some paucity of good evidence to guide uniformity in the various aspects of trabeculectomy.