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Abstract

Background: Academic institutions must balance resident training with patient safety. Studies have demonstrated that residents can perform trabeculectomies with no increased risk to patients, but there is limited data for other glaucoma surgeries.

Purpose: To describe the surgical outcomes of resident-performed Baerveldt-350 implantations at a single institution.

Methods: Eyes undergoing Baerveldt-350 implantation at the University of Chicago Medicine between 30 August and 1 November 2023 with an ophthalmology resident as primary surgeon were included. Patients with neovascular glaucoma and/or prior aqueous shunt implantation were excluded. Retrospective chart review was performed from the preoperative visit to postoperative month (POM) 12. The main outcome was surgical success at POM12, defined as nonfailure. Failure was defined as need for reoperation; loss of light perception; or two consecutive visits, starting at POM3, with intraocular pressure (IOP) ≤5 mm Hg or >21 mm Hg or a reduction from preoperative IOP of <20%.

Results: A total of 83 eyes from 71 patients underwent Baerveldt-350 implantation. Surgical success at POM12 was 80.5%. Mean IOP decreased from 23.2 ± 9.0 mm Hg on 4.1 ±1.1 medications to 11.2 ± 3.3 mm Hg on 2.5 ± 1.5 medications. Hyphema (18%) and cystoid macular edema (14%) were the most common postoperative complications. Twenty-seven (33%) eyes underwent tube shunt implantation alone, whereas 56 (67%) underwent concurrent phacoemulsification or goniotomy. Success rates, IOP, and medication burden were similar between the two groups. Concurrent goniotomy was significantly associated with higher rates of hyphema (p = 0.001).

Conclusions: Ophthalmology residents under the appropriate supervision of a glaucoma specialist can perform tube shunt implantations without increased risk to patients.

Received Date

27/06/2025

Revised Date

01/10/2025

Accepted Date

10/11/2025

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