Microinvasive Glaucoma Surgery in United States Ophthalmology Residency: Surgical Case Log Cross-sectional Analysis and Proposal for New Glaucoma Procedure Classification

Date Published:

2021 Apr 06


PRECIS: A cross-sectional sample of the United States ophthalmology residency graduating class of 2018 revealed that 18.4% of residents logged less than 5 traditional glaucoma surgeries, and 63.4% logged at least one microinvasive glaucoma surgery. PURPOSE: Describe the state of microinvasive glaucoma surgery in United States ophthalmology residency training and propose a glaucoma procedure classification system for residents' surgical case logs. METHODS: Deidentified case logs from residents graduating in 2018 were requested from United States residency program directors. RESULTS: Case logs were received for 152/488 (31%) residents from 36/115 (31%) programs. The mean number of traditional glaucoma surgeries per resident was 9.0±5.9 (range 0-31). The mean number of microinvasive glaucoma surgery per resident was 5.2±8.9 cases (range 0-58). There were 28/152 (18.4%) residents from 16/36 (44.4%) programs who logged <5 traditional glaucoma surgeries, and 3/152 (2.0%) residents from 3/36 (8.3%) programs who logged zero traditional glaucoma surgeries. There were 98/152 (64.5%) residents from 32/36 (88.8%) programs who logged <5 microinvasive glaucoma surgery as primary surgeon, and 48/152 (31.6%) residents from 25 of 36 (69.4%) programs who logged zero microinvasive glaucoma surgery. There were 104/152 (63.4%) residents from 33/36 (91.6%) programs who logged at least 1 microinvasive glaucoma surgery; there were 3/36 (8.3%) residency programs where no resident logged any microinvasive glaucoma surgery. CONCLUSIONS: United States ophthalmology residents' microinvasive glaucoma surgery experience varies widely. Residents can satisfy glaucoma surgery requirements with some microinvasive glaucoma surgery, even in the absence of adequate traditional glaucoma surgeries. We propose a residency case log classification system that better reflects the growing role of microinvasive glaucoma surgery in clinical practice and helps ophthalmic educators more accurately track procedures requiring related skills.

Last updated on 05/01/2021