Trabeculectomy training in England: are we safe at training? Two year surgical outcomes
Objectives To define the safety profile of trainee trabeculectomy surgery in the United Kingdom. Surgical exposure for trainees in England is limited due to service requirements, the European working time directive constraints and increasing sub-specialisation of glaucoma surgery. Limited knowledge...
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| Veröffentlicht in: | Eye (London) 2018-07, Vol.32 (7), p.1253-1258 |
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| creator | Walkden, A. Huxtable, J. Senior, M. Lee, H. Naylor, S. Turner, S. Ivanova, K. Koppens, J. Todd, B. Macleod, A. Sii, F. Anand, N. Shah, P. King, A. Broadway, D. C. Kirwan, J. F. McNaught, A. Bhan-Bhargava, A. |
| description | Objectives
To define the safety profile of trainee trabeculectomy surgery in the United Kingdom. Surgical exposure for trainees in England is limited due to service requirements, the European working time directive constraints and increasing sub-specialisation of glaucoma surgery. Limited knowledge exists on the outcomes of supervised glaucoma surgery. The aim is to determine the safety of supervised trabeculectomy surgery performed by trainee ophthalmologists.
Methods
Retrospective case note review of all patients that had trabeculectomy surgery with MMC by consultant and trainee surgeons across multiple UK centres. All eyes have 2-year follow up. Success was determined using WGA guidelines. Two-tailed
p
values were obtained using Fisher’s exact test to ascertain statistical significance between groups. Main outcome measures: intraocular pressure, visual acuity, success and failure rates.
Results
324 eyes were reviewed. 211 (66.4%) cases were performed by glaucoma consultants, 107(33.6%) by trainee ophthalmologists. The majority of eyes in each group were undergoing surgery for POAG. Post-operative IOP control showed no significant difference between consultant and trainee groups at year 1 and year 2. Success rates showed no significant difference between consultant and trainee cases. Failure rates at year 1 showed a significant difference between the two groups. No significant difference was seen at year 2. The trainee group had significantly more complications, when compared with the consultant group. Snellen visual acuity loss was not statistically significant between the two groups at the 2 year time point.
Conclusions
The outcomes of supervised trainee trabeculectomy compare favourably with consultant cases after 2 year follow up. Trainee cases had higher complication rates than consultant cases. Bleb leaks are a common complication of trainee cases, where closer supervision may be required. There is potential for surgical simulation to help increase the success of such cases. These findings may encourage trainee participation in glaucoma surgery. |
| doi_str_mv | 10.1038/s41433-018-0059-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6043552</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2013102725</sourcerecordid><originalsourceid>FETCH-LOGICAL-c470t-8376b9ca8e761f7621d994e90b02bbe3ae302c376bb49244bda7a6372a5329d23</originalsourceid><addsrcrecordid>eNp1kUtv1DAUhS0EotPCD2CDLLFhE7h-xyyoUNUCUiU2g2BnOc6dkCqJi51Qzb_H0ZThIbHy4nz3-J57CHnG4BUDUb_OkkkhKmB1BaBspR-QDZNGV0oq-ZBswCqoOOdfT8hpzjcARTTwmJxwq7gBJjbkyzb5BsMyYJjjuKdz8v3UTx3tJ3o5dYOf2jfUJ6R3SLPfIfXzkTmn27tI9-gTzUvq-uAHGpc5xBHzE_Jo54eMT-_fM_L56nJ78aG6_vT-48W76ypIA3NVC6MbG3yNRrOd0Zy11kq00ABvGhQeBfCwQo20XMqm9cZrYbhXgtuWizPy9uB7uzQjtgGnst3gblM_-rR30ffub2Xqv7ku_nAapFBqNXh5b5Di9wXz7MY-BxxKcoxLdryciQE3XBX0xT_oTVzSVOIVStcWuICVYgcqpJhzwt1xGQZurc0danOlNrfW5nSZef5niuPEr54KwA9ALtLUYfr99f9dfwIHb6LR</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2068902305</pqid></control><display><type>article</type><title>Trabeculectomy training in England: are we safe at training? Two year surgical outcomes</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>SpringerLink Journals - AutoHoldings</source><creator>Walkden, A. ; Huxtable, J. ; Senior, M. ; Lee, H. ; Naylor, S. ; Turner, S. ; Ivanova, K. ; Koppens, J. ; Todd, B. ; Macleod, A. ; Sii, F. ; Anand, N. ; Shah, P. ; King, A. ; Broadway, D. C. ; Kirwan, J. F. ; McNaught, A. ; Bhan-Bhargava, A.</creator><creatorcontrib>Walkden, A. ; Huxtable, J. ; Senior, M. ; Lee, H. ; Naylor, S. ; Turner, S. ; Ivanova, K. ; Koppens, J. ; Todd, B. ; Macleod, A. ; Sii, F. ; Anand, N. ; Shah, P. ; King, A. ; Broadway, D. C. ; Kirwan, J. F. ; McNaught, A. ; Bhan-Bhargava, A.</creatorcontrib><description>Objectives
To define the safety profile of trainee trabeculectomy surgery in the United Kingdom. Surgical exposure for trainees in England is limited due to service requirements, the European working time directive constraints and increasing sub-specialisation of glaucoma surgery. Limited knowledge exists on the outcomes of supervised glaucoma surgery. The aim is to determine the safety of supervised trabeculectomy surgery performed by trainee ophthalmologists.
Methods
Retrospective case note review of all patients that had trabeculectomy surgery with MMC by consultant and trainee surgeons across multiple UK centres. All eyes have 2-year follow up. Success was determined using WGA guidelines. Two-tailed
p
values were obtained using Fisher’s exact test to ascertain statistical significance between groups. Main outcome measures: intraocular pressure, visual acuity, success and failure rates.
Results
324 eyes were reviewed. 211 (66.4%) cases were performed by glaucoma consultants, 107(33.6%) by trainee ophthalmologists. The majority of eyes in each group were undergoing surgery for POAG. Post-operative IOP control showed no significant difference between consultant and trainee groups at year 1 and year 2. Success rates showed no significant difference between consultant and trainee cases. Failure rates at year 1 showed a significant difference between the two groups. No significant difference was seen at year 2. The trainee group had significantly more complications, when compared with the consultant group. Snellen visual acuity loss was not statistically significant between the two groups at the 2 year time point.
Conclusions
The outcomes of supervised trainee trabeculectomy compare favourably with consultant cases after 2 year follow up. Trainee cases had higher complication rates than consultant cases. Bleb leaks are a common complication of trainee cases, where closer supervision may be required. There is potential for surgical simulation to help increase the success of such cases. These findings may encourage trainee participation in glaucoma surgery.</description><identifier>ISSN: 0950-222X</identifier><identifier>EISSN: 1476-5454</identifier><identifier>DOI: 10.1038/s41433-018-0059-6</identifier><identifier>PMID: 29527013</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/308 ; 692/699/3161 ; Acuity ; Adult ; Aged ; Aged, 80 and over ; Education, Medical, Continuing - standards ; England ; Eye ; Eye surgery ; Female ; Glaucoma ; Humans ; Intraocular Pressure ; Laboratory Medicine ; Male ; Medical personnel ; Medicine ; Medicine & Public Health ; Middle Aged ; Ophthalmology ; Patient Safety ; Pharmaceutical Sciences/Technology ; Postoperative Complications ; Retrospective Studies ; Statistical analysis ; Success ; Surgery ; Surgical Oncology ; Surgical outcomes ; Trabeculectomy - education ; Visual Acuity</subject><ispartof>Eye (London), 2018-07, Vol.32 (7), p.1253-1258</ispartof><rights>The Royal College of Ophthalmologists 2018</rights><rights>Copyright Nature Publishing Group Jul 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-8376b9ca8e761f7621d994e90b02bbe3ae302c376bb49244bda7a6372a5329d23</citedby><cites>FETCH-LOGICAL-c470t-8376b9ca8e761f7621d994e90b02bbe3ae302c376bb49244bda7a6372a5329d23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6043552/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6043552/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,41464,42533,51294,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29527013$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Walkden, A.</creatorcontrib><creatorcontrib>Huxtable, J.</creatorcontrib><creatorcontrib>Senior, M.</creatorcontrib><creatorcontrib>Lee, H.</creatorcontrib><creatorcontrib>Naylor, S.</creatorcontrib><creatorcontrib>Turner, S.</creatorcontrib><creatorcontrib>Ivanova, K.</creatorcontrib><creatorcontrib>Koppens, J.</creatorcontrib><creatorcontrib>Todd, B.</creatorcontrib><creatorcontrib>Macleod, A.</creatorcontrib><creatorcontrib>Sii, F.</creatorcontrib><creatorcontrib>Anand, N.</creatorcontrib><creatorcontrib>Shah, P.</creatorcontrib><creatorcontrib>King, A.</creatorcontrib><creatorcontrib>Broadway, D. C.</creatorcontrib><creatorcontrib>Kirwan, J. F.</creatorcontrib><creatorcontrib>McNaught, A.</creatorcontrib><creatorcontrib>Bhan-Bhargava, A.</creatorcontrib><title>Trabeculectomy training in England: are we safe at training? Two year surgical outcomes</title><title>Eye (London)</title><addtitle>Eye</addtitle><addtitle>Eye (Lond)</addtitle><description>Objectives
To define the safety profile of trainee trabeculectomy surgery in the United Kingdom. Surgical exposure for trainees in England is limited due to service requirements, the European working time directive constraints and increasing sub-specialisation of glaucoma surgery. Limited knowledge exists on the outcomes of supervised glaucoma surgery. The aim is to determine the safety of supervised trabeculectomy surgery performed by trainee ophthalmologists.
Methods
Retrospective case note review of all patients that had trabeculectomy surgery with MMC by consultant and trainee surgeons across multiple UK centres. All eyes have 2-year follow up. Success was determined using WGA guidelines. Two-tailed
p
values were obtained using Fisher’s exact test to ascertain statistical significance between groups. Main outcome measures: intraocular pressure, visual acuity, success and failure rates.
Results
324 eyes were reviewed. 211 (66.4%) cases were performed by glaucoma consultants, 107(33.6%) by trainee ophthalmologists. The majority of eyes in each group were undergoing surgery for POAG. Post-operative IOP control showed no significant difference between consultant and trainee groups at year 1 and year 2. Success rates showed no significant difference between consultant and trainee cases. Failure rates at year 1 showed a significant difference between the two groups. No significant difference was seen at year 2. The trainee group had significantly more complications, when compared with the consultant group. Snellen visual acuity loss was not statistically significant between the two groups at the 2 year time point.
Conclusions
The outcomes of supervised trainee trabeculectomy compare favourably with consultant cases after 2 year follow up. Trainee cases had higher complication rates than consultant cases. Bleb leaks are a common complication of trainee cases, where closer supervision may be required. There is potential for surgical simulation to help increase the success of such cases. These findings may encourage trainee participation in glaucoma surgery.</description><subject>692/308</subject><subject>692/699/3161</subject><subject>Acuity</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Education, Medical, Continuing - standards</subject><subject>England</subject><subject>Eye</subject><subject>Eye surgery</subject><subject>Female</subject><subject>Glaucoma</subject><subject>Humans</subject><subject>Intraocular Pressure</subject><subject>Laboratory Medicine</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Ophthalmology</subject><subject>Patient Safety</subject><subject>Pharmaceutical Sciences/Technology</subject><subject>Postoperative Complications</subject><subject>Retrospective Studies</subject><subject>Statistical analysis</subject><subject>Success</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Surgical outcomes</subject><subject>Trabeculectomy - education</subject><subject>Visual Acuity</subject><issn>0950-222X</issn><issn>1476-5454</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kUtv1DAUhS0EotPCD2CDLLFhE7h-xyyoUNUCUiU2g2BnOc6dkCqJi51Qzb_H0ZThIbHy4nz3-J57CHnG4BUDUb_OkkkhKmB1BaBspR-QDZNGV0oq-ZBswCqoOOdfT8hpzjcARTTwmJxwq7gBJjbkyzb5BsMyYJjjuKdz8v3UTx3tJ3o5dYOf2jfUJ6R3SLPfIfXzkTmn27tI9-gTzUvq-uAHGpc5xBHzE_Jo54eMT-_fM_L56nJ78aG6_vT-48W76ypIA3NVC6MbG3yNRrOd0Zy11kq00ABvGhQeBfCwQo20XMqm9cZrYbhXgtuWizPy9uB7uzQjtgGnst3gblM_-rR30ffub2Xqv7ku_nAapFBqNXh5b5Di9wXz7MY-BxxKcoxLdryciQE3XBX0xT_oTVzSVOIVStcWuICVYgcqpJhzwt1xGQZurc0danOlNrfW5nSZef5niuPEr54KwA9ALtLUYfr99f9dfwIHb6LR</recordid><startdate>20180701</startdate><enddate>20180701</enddate><creator>Walkden, A.</creator><creator>Huxtable, J.</creator><creator>Senior, M.</creator><creator>Lee, H.</creator><creator>Naylor, S.</creator><creator>Turner, S.</creator><creator>Ivanova, K.</creator><creator>Koppens, J.</creator><creator>Todd, B.</creator><creator>Macleod, A.</creator><creator>Sii, F.</creator><creator>Anand, N.</creator><creator>Shah, P.</creator><creator>King, A.</creator><creator>Broadway, D. C.</creator><creator>Kirwan, J. F.</creator><creator>McNaught, A.</creator><creator>Bhan-Bhargava, A.</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180701</creationdate><title>Trabeculectomy training in England: are we safe at training? Two year surgical outcomes</title><author>Walkden, A. ; Huxtable, J. ; Senior, M. ; Lee, H. ; Naylor, S. ; Turner, S. ; Ivanova, K. ; Koppens, J. ; Todd, B. ; Macleod, A. ; Sii, F. ; Anand, N. ; Shah, P. ; King, A. ; Broadway, D. C. ; Kirwan, J. F. ; McNaught, A. ; Bhan-Bhargava, A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-8376b9ca8e761f7621d994e90b02bbe3ae302c376bb49244bda7a6372a5329d23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>692/308</topic><topic>692/699/3161</topic><topic>Acuity</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Education, Medical, Continuing - standards</topic><topic>England</topic><topic>Eye</topic><topic>Eye surgery</topic><topic>Female</topic><topic>Glaucoma</topic><topic>Humans</topic><topic>Intraocular Pressure</topic><topic>Laboratory Medicine</topic><topic>Male</topic><topic>Medical personnel</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Ophthalmology</topic><topic>Patient Safety</topic><topic>Pharmaceutical Sciences/Technology</topic><topic>Postoperative Complications</topic><topic>Retrospective Studies</topic><topic>Statistical analysis</topic><topic>Success</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Surgical outcomes</topic><topic>Trabeculectomy - education</topic><topic>Visual Acuity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Walkden, A.</creatorcontrib><creatorcontrib>Huxtable, J.</creatorcontrib><creatorcontrib>Senior, M.</creatorcontrib><creatorcontrib>Lee, H.</creatorcontrib><creatorcontrib>Naylor, S.</creatorcontrib><creatorcontrib>Turner, S.</creatorcontrib><creatorcontrib>Ivanova, K.</creatorcontrib><creatorcontrib>Koppens, J.</creatorcontrib><creatorcontrib>Todd, B.</creatorcontrib><creatorcontrib>Macleod, A.</creatorcontrib><creatorcontrib>Sii, F.</creatorcontrib><creatorcontrib>Anand, N.</creatorcontrib><creatorcontrib>Shah, P.</creatorcontrib><creatorcontrib>King, A.</creatorcontrib><creatorcontrib>Broadway, D. C.</creatorcontrib><creatorcontrib>Kirwan, J. F.</creatorcontrib><creatorcontrib>McNaught, A.</creatorcontrib><creatorcontrib>Bhan-Bhargava, A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Eye (London)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Walkden, A.</au><au>Huxtable, J.</au><au>Senior, M.</au><au>Lee, H.</au><au>Naylor, S.</au><au>Turner, S.</au><au>Ivanova, K.</au><au>Koppens, J.</au><au>Todd, B.</au><au>Macleod, A.</au><au>Sii, F.</au><au>Anand, N.</au><au>Shah, P.</au><au>King, A.</au><au>Broadway, D. C.</au><au>Kirwan, J. F.</au><au>McNaught, A.</au><au>Bhan-Bhargava, A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Trabeculectomy training in England: are we safe at training? Two year surgical outcomes</atitle><jtitle>Eye (London)</jtitle><stitle>Eye</stitle><addtitle>Eye (Lond)</addtitle><date>2018-07-01</date><risdate>2018</risdate><volume>32</volume><issue>7</issue><spage>1253</spage><epage>1258</epage><pages>1253-1258</pages><issn>0950-222X</issn><eissn>1476-5454</eissn><abstract>Objectives
To define the safety profile of trainee trabeculectomy surgery in the United Kingdom. Surgical exposure for trainees in England is limited due to service requirements, the European working time directive constraints and increasing sub-specialisation of glaucoma surgery. Limited knowledge exists on the outcomes of supervised glaucoma surgery. The aim is to determine the safety of supervised trabeculectomy surgery performed by trainee ophthalmologists.
Methods
Retrospective case note review of all patients that had trabeculectomy surgery with MMC by consultant and trainee surgeons across multiple UK centres. All eyes have 2-year follow up. Success was determined using WGA guidelines. Two-tailed
p
values were obtained using Fisher’s exact test to ascertain statistical significance between groups. Main outcome measures: intraocular pressure, visual acuity, success and failure rates.
Results
324 eyes were reviewed. 211 (66.4%) cases were performed by glaucoma consultants, 107(33.6%) by trainee ophthalmologists. The majority of eyes in each group were undergoing surgery for POAG. Post-operative IOP control showed no significant difference between consultant and trainee groups at year 1 and year 2. Success rates showed no significant difference between consultant and trainee cases. Failure rates at year 1 showed a significant difference between the two groups. No significant difference was seen at year 2. The trainee group had significantly more complications, when compared with the consultant group. Snellen visual acuity loss was not statistically significant between the two groups at the 2 year time point.
Conclusions
The outcomes of supervised trainee trabeculectomy compare favourably with consultant cases after 2 year follow up. Trainee cases had higher complication rates than consultant cases. Bleb leaks are a common complication of trainee cases, where closer supervision may be required. There is potential for surgical simulation to help increase the success of such cases. These findings may encourage trainee participation in glaucoma surgery.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>29527013</pmid><doi>10.1038/s41433-018-0059-6</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Eye (London), 2018-07, Vol.32 (7), p.1253-1258 |
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| language | eng |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; PubMed Central; SpringerLink Journals - AutoHoldings |
| subjects | 692/308 692/699/3161 Acuity Adult Aged Aged, 80 and over Education, Medical, Continuing - standards England Eye Eye surgery Female Glaucoma Humans Intraocular Pressure Laboratory Medicine Male Medical personnel Medicine Medicine & Public Health Middle Aged Ophthalmology Patient Safety Pharmaceutical Sciences/Technology Postoperative Complications Retrospective Studies Statistical analysis Success Surgery Surgical Oncology Surgical outcomes Trabeculectomy - education Visual Acuity |
| title | Trabeculectomy training in England: are we safe at training? Two year surgical outcomes |
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