Abstract
Purpose The aim of the study is to assess the state of glaucoma surgical training in United
States ophthalmology residency programs, including experience with microinvasive glaucoma
surgery (MIGS).
Design The design of the study is anonymous, internet-based national survey.
Participants Current United States ophthalmology residents of residency programs accredited by
the Accreditation Council for Graduate Medical Education (ACGME).
Methods An anonymous survey link was emailed to all 120 accredited United States ophthalmology
residency programs inviting residents to participate in an assessment of residency
glaucoma surgical experience. Survey responses were collected between January 21,
2019 and March 4, 2019 and analyzed using descriptive statistics.
Main Outcome Measures The main outcomes of the study are demographic information, practice intentions, and anticipated primary surgical experience
with ACGME-required glaucoma procedures and MIGS procedures, as self-reported by U.S.
ophthalmology residents.
Results Of the estimated 1,479 U.S. ophthalmology residents, 161 residents participated (10.9%).
A total of 118 residents (73.2%) reported any degree of anticipated MIGS primary surgical
experience during residency, with the iStent being the most familiar technique. The
likelihood of any anticipated MIGS experience during residency was not significantly
different by geographic region (p = 0.16), however, anticipated volume varied significantly (p = 0.037). Of the 113 respondents who reported an intention to manage glaucoma surgically
in their eventual practice, 25 (22.1%) reported no anticipated primary MIGS experience
during residency. 73.3% of residents anticipating MIGS experience anticipated 0 to
10 cases, with 42.9% anticipating less than 5 cases as primary surgeon.
Conclusion MIGs are not a required component of the glaucoma surgical curriculum for U.S. ophthalmology
residents. Although the majority of ophthalmology residents surveyed intend to manage
glaucoma surgically in eventual practice, most receive minimal experience with these
novel techniques during residency. Surgical training is variable by geographic region.
Keywords
glaucoma - microinvasive glaucoma surgery - residents - surgical experience
