Evaluation of the learning curve of non-penetrating glaucoma surgery

Int Ophthalmol. 2018 Oct;38(5):2005-2012. doi: 10.1007/s10792-017-0691-3. Epub 2017 Aug 11.


Purpose: To evaluate the learning curve of non-penetrating glaucoma surgery (NPGS).

Methods: The study included 32 eyes of 27 patients' (20 male and 7 female) with medically uncontrolled glaucoma. Non-penetrating glaucoma surgeries performed by trainees under control of an experienced surgeon between 2005 and 2007 at our tertiary referral hospital were evaluated. Residents were separated into two groups. Humanistic training model applied to the one in the first group, he studied with experimental models before performing NPGS. Two residents in the second group performed NPGS after a conventional training model. Surgeries of the residents were recorded on video and intraoperative parameters were scored by the experienced surgeon at the end of the study. Postoperative intraocular pressure, absolute and total success rates were analyzed.

Results: In the first group 19 eyes of 16 patients and in the second group 13 eyes of 11 patients had been operated by residents. Intraoperative parameters and complication rates were not statistically significant between groups (p > 0.05, Chi-square). The duration of surgery was 32.7 ± 5.6 min in the first group and 45 ± 3.8 min in the second group. The difference was statistically significant (p < 0.001, Student's t test). Absolute and total success was 68.8 and 93.8% in the first group and 62.5 and 87.5% in the second group, respectively. The difference was not statistically significant.

Conclusions: Humanistic and conventional training models under control of an experienced surgeon are safe and effective for senior residents who manage phacoemulsification surgery in routine cataract cases. Senior residents can practice these surgical techniques with reasonable complication rates.

Keywords: Deep sclerectomy; Learning curve; Non-penetrating glaucoma surgery; Training model; Viscocanalostomy.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Education, Medical, Graduate / methods*
  • Female
  • Filtering Surgery / education*
  • Glaucoma / physiopathology
  • Glaucoma / surgery*
  • Humans
  • Internship and Residency*
  • Intraocular Pressure*
  • Learning Curve*
  • Male
  • Middle Aged
  • Operative Time
  • Ophthalmologists / education*
  • Ophthalmology / education*
  • Postoperative Period
  • Video Recording