Biomedical subjects

R Troutbeck

Publications and source records attributed to R Troutbeck.

5 recordsLinked to original sources

PubMed2005

Trabeculectomy: a training dilemma.

AIM/PURPOSE: The incidence of trabeculectomy is falling due to more effective medical therapies, resulting in fewer trabeculectomy operations carried out by Ophthalmology trainees. This study audits all primary trabeculectomy procedures performed publicly at the two major teaching hospitals in Brisbane, Australia. METHOD: A retrospective consecutive case review analysing the rates and outcomes of Ophthalmology trainee versus consultant trabeculectomies that were performed during the period May 1996-May 2002. RESULTS: In all, 290 primary trabeculectomies were undertaken during the study period. Ophthalmology trainees performed 95 (33%) of the procedures. This represents a rate of 1.6 trabeculectomy procedures per year per trainee (10 trainees train at the two hospitals per year). Rates of complications postoperatively were similar between the trainee and consultant groups. The percentage of patients achieving an IOP < or =15 mmHg on no medication at their last follow-up was low at 30%. CONCLUSIONS: The results of this study suggests that improvement in trabeculectomy technique is required. In order to acquire skills, wetlab training on artificial or animal eyes may become mandatory within the training programmes, otherwise trabeculectomy will become the realm of sub-specialists with glaucoma fellowship training.

Adult↗

PubMed2001

Review of treatment of pterygium in Queensland: 10 years after a primary survey.

PURPOSE: To assess the practices in pterygium removal as a follow-up study to a similar project 10 years ago, in order to compare the current trends with those noted a decade ago. METHODS: A survey was sent to all practising ophthalmologists in Queensland (100). RESULTS: Eighty-seven of the 100 ophthalmologists undertook pterygium surgery with no change in indications for removal, grading or anaesthesia compared to 10 years ago. Nearly half of the ophthalmologists varied their surgical technique from eight commonly used methods according to the individual patient. More than half the respondents used a swinging conjunctival flap and 29% used simple excision leaving the area bare for primary pterygia, although nearly one-quarter of the ophthalmologists added adjunctive therapies such as beta irradiat on or mitomycin. For recurrent pterygia, one-third of ophthalmologists preferred adjunctve therapies, and 57% used an autoconjunctival transplant. CONCLUSION: There has been no consistent trend in surgical removal of pterygia with a significant number of primary pterygia still removed using bare scleral closure.

Anesthesia, Local↗

PubMed1995

Elderly drivers and simulated visual impairment.

BACKGROUND: The effect of simulated visual impairment on the driving performance of elderly subjects and the relation between changes in driving performance and vision were investigated. METHODS: Vision was impaired by goggles simulating the effects of cataracts, binocular visual field restriction, and monocularity. Driving was assessed on a road circuit free of other vehicles. Visual performance was measured using the Humphrey Field Analyser (HFA), the Useful Field of View (UFOV), and the Pelli-Robson chart. RESULTS: The simulated visual impairment significantly decreased driving performance, even though all drivers satisfied the legal visual requirements for driving. Significant correlations between driving performance and the UFOV and Pelli-Robson chart were found.

Aged↗

PubMed1994

Effect of visual impairment on driving.

The aim of the study was to determine the effect on driving of restricting vision. This was undertaken by comparing the driving performance of young, normal subjects under conditions of simulated visual impairment with a baseline condition. Visual impairment was simulated using goggles designed to replicate the effects of cataracts, binocular visual field restriction, and monocular vision. All subjects had binocular visual acuity greater than 6/12 when wearing the goggles and thus satisfied the visual requirements for a driver's license. Driving performance was assessed on a closed-road circuit for a series of driving tasks including peripheral awareness, maneuvering, reversing, reaction time, speed estimation, road position, and time to complete the course. Simulated cataract resulted in the greatest detriment to driving performance, followed by binocular visual field restriction. The monocular condition did not significantly affect driving performance for any of the driving tasks assessed.

Adult↗

PubMed1992

Effect of restriction of the binocular visual field on driving performance.

The importance of the visual field on driving performance was investigated. This was undertaken by simulating binocular visual field defects for a group of young normal subjects and assessing the impact of these defects on performance on a driving course. Constriction of the binocular visual field to 40 or less, significantly increased time taken to complete the course, reduced the ability to detect and correctly identify road signs, avoid obstacles and to manoeuvre through limited spaces. Accuracy of road positioning and reversing were also impaired. Constriction of the binocular visual field did not significantly affect speed estimation, stopping distance, or the time taken for the reversing and manoeuvring tasks. The monocular condition did not significantly affect performance for any of the driving tasks assessed.

Adult↗