Changing trends in glaucoma surgery within Australia

Abstract

BackgroundLimited data are available on glaucoma surgical trends in Australia.MethodsNationwide study of glaucoma surgery in Australia over 17-year period from 2001 to 2018. The Australian Institute of Health, Welfare and Ageing hospitalisation database was used to review age- and gender-specific trends in glaucoma surgeries from 2001 to 2018 in Australian public and private hospitals.ResultsAlthough there was an increase in the absolute number of trabeculectomy procedures from 2926 to 3244 over the 17-year study period, this represented a decline in the age-standardised and gender-standardised number of trabeculectomy procedures from 15.1 to 13.2 procedures per 100 000 persons. However, during this same period, there was a dramatic increase in the number of glaucoma drainage devices (GDD) from 119 to 3262 procedures, representing an age-standardised and gender-standardised increase from 0.6 to 13.3 procedures per 100 000 persons. Negative binomial regression analysis revealed a decrease in trabeculectomy procedures of 1.1% per year, while there was increase in GDD insertions of 16.3% per year (p<0.001 for both). When stratified by age group, there was a statistically significant interaction in both trabeculectomy and GDD rates by age groups over time (p<0.001 for both). Trabeculectomy procedures decreased to a greater extent in those aged >60 years, compared with stable or increasing rates in younger age groups. GDD insertion rates demonstrated a progressively greater increase in older compared with younger age groups.ConclusionOur findings demonstrate changing trends in the surgical management of advanced glaucoma in Australia, likely reflecting updated evidence regarding the role of GDD surgeries.

Nationwide Analysis of Glaucoma Surgeries in Fiscal Years of 2014 and 2020 in Japan

“…In Scotland, England, and Wales, the overall trabeculectomy rates per 100,000 persons remained stable from 9.06 in 2003 to 10.76 in 2012 [33]. In Australia, the numbers of trabeculectomies per 100,000 persons were 15.1 in the year 2001 and 13.2 in 2018, while for tube shunt surgery, this was 0.6 in the year 2001 and 13.3 in 2018 [34]. None of the prefectural vital statistics were significantly associated with the number of glaucoma surgeries.…”

Short-Term Postoperative Outcome of Baerveldt Glaucoma Implant with Two Tubes Inserted into the Vitreous Cavity

“…Based on these results, even though trabeculectomy has been the gold standard in glaucoma surgery, tube shunt surgery is becoming increasingly popular. Recent statistics reveal that trabeculectomy and tube-shunt surgeries are performed in equal numbers in United States and Australia [4,5].…”

Real-World Outcomes of Glaucoma Filtration Surgery Using Electronic Health Records: An Informatics Study

“…Although traditionally, tube shunt surgery was reserved for those who had either failed trabeculectomy or were at high risk of failure, the Tube Versus Trabeculectomy study and Primary Tube Versus Trabeculectomy studies have supported an expanding role of tube shunts beyond refractory glaucoma 3–5. As such, changing practice patterns have been observed worldwide with increasing rates of tube shunt procedures relative to trabeculectomy 6,7. However, real-world outcomes comparing various filtration surgeries, particularly for patients undergoing primary tube shunt insertion, remain limited.…”

“…[3][4][5] As such, changing practice patterns have been observed worldwide with increasing rates of tube shunt procedures relative to trabeculectomy. 6,7 However, real-world outcomes comparing various filtration surgeries, particularly for patients undergoing primary tube shunt insertion, remain limited. We thus sought to evaluate the long-term survival of glaucoma filtration procedures using an automated pipeline for extraction of surgical outcomes from EHR.…”