Audit and Research

The number of glaucoma procedures, patients’ ages, and diagnoses made and success rates for the various glaucoma procedures performed are shown in Figures 4.1 to 4.6.

In the 2010 surgical audit, the overall success rate of trabeculectomy (TRAB) in primary glaucoma was 98.8%, whereas that of aqueous shunt surgery was 94.6%. The overall success rate of combined TRAB and cataract surgery was 98.5%.

Of the total success cases, 7.6% experienced an increase in IOP 12 months post-operation (TRAB : 5 [4.2%]; TRAB/cataract: 25 [10.3%]).

	SNEC 2011	SNEC 2012	SNEC 2013	TVT RCT(Gedde et al., 2007b)	ABC RCT (Budenz et al., 2011)	Bascom Palmer Eye Institute (Scott et al., 1998)	UK National Study (Edmunds, Thompson, Salmon & Wormald, 2001)
TRAB	Overall 92.2% (N = 103); Primary 91.2% (N = 68)	Overall 97.3% (N = 147); Primary 98.9% (N = 95)	Overall 95.9% (N = 123); Primary 98.8% (N = 84)	87% (N = 100) Mainly primary glaucoma	-	92.7% (N = 89) Mainly primary glaucoma	92% (N = 1,240) Mainly primary glaucoma
Seton implant	Overall 97.3% (N = 37)	Overall 93.2% (N = 44)	Overall 97.4% (N = 38)	Primary 96% (N = 104)	83.6% (N=143)	-	-

SNEC 2011

SNEC 2012

SNEC 2013

TVT RCT(Gedde et al., 2007b)

ABC RCT (Budenz et al., 2011)

Bascom Palmer Eye Institute (Scott et al., 1998)

UK National Study (Edmunds, Thompson, Salmon & Wormald, 2001)

TRAB

Overall 92.2%

(N = 103);

Primary 91.2%

(N = 68)

Overall 97.3%

(N = 147); Primary 98.9%

(N = 95)

Overall 95.9%

(N = 123); Primary 98.8%

(N = 84)

87%

(N = 100) Mainly primary glaucoma

92.7%

(N = 89) Mainly primary glaucoma

92%

(N = 1,240) Mainly primary glaucoma

Seton implant

Overall 97.3%

(N = 37)

Overall 93.2%

(N = 44)

Overall 97.4%

(N = 38)

Primary 96%

(N = 104)

83.6%

(N=143)

ARC, Ahmed Baerveldt comparison; PACG, primary angle-closure glaucoma; POAG, primary open-angle glaucoma; RCT, randomised clinical trial; TRAB, trabeculectomy; TVT, tube versus trabeculectomy

Table 4.2. Comparison of TRAB complication rates with international studies
	SNEC 2011 (N = 380) (%)	SNEC 2012 (N = 420) (%)	SNEC 2013 (N = 369) (%)	AGIS (AGIS Investigators, 2002) (N = 509) (%)	CIGTS (Jampel et al., 2005) (N = 465)(%)	TVT study (Gedde et al., 2007a) (N = 105) (%)
Overfiltration	8.7	7.6	5.7	15.5	13.9	10
Wound leak	7.6	6.2	6.0	6.5	6	11
Endophthalmitis	0	0	0	=	=	3
Cataract	-	-	0	4.1	17.3	48
Hyphema	3.4	3.3	6.8	11.4	10	8
Suprachoroidal haemorrhage	0	0	0	-	0.7	3
Malignant glaucoma	0	0.2	0	-	0.4	1

ABC, Ahmed Baerveldt comparison; AVB, Ahmed versus Baerveldt; TVT, tube versus trabeculectomy

Latest audit results

Of the glaucoma procedures performed in 2013, 488 of the 502 glaucoma surgery cases were audited (N – 452). In the independent annual surgical audit, success is defined as an achievement of an IOP ≤21 mm Hg at the end of the first post-operative year.