&lt;p&gt;GlaucoMap – Distribution of Glaucoma Surgical Procedures in the United States&lt;/p&gt;

Anthony, K; Lee, Jun Hui; Warren, Joshua L.; Teng, Christopher C.

doi:10.2147/opth.s257361

Cited by 31 publications

(44 citation statements)

References 23 publications

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“…No current studies examine the role of IC antibiotics in GDI surgeries, which are increasing in frequency 2. Furthermore, no studies examine the role of IC antibiotics and MIGS, which are now the most common glaucoma surgeries performed in the United States 1,2. The benefit of IC antibiotics after non–bleb-forming MIGS may be similar to that of cataract surgery based on the likenesses in surgical technique, but this has yet to be formally examined, and most current trials are underpowered to assess this endpoint.…”

Section: Discussionmentioning

confidence: 99%

“…These were the first 2 MIGS devices approved in the United States. Since that time, many other devices have entered the market, and MIGS are now the most commonly performed glaucoma surgeries in the United States 1,2. Data regarding postoperative infection is limited given the relative novelty and rapidly evolving technology.…”

Section: Infection In Glaucoma Surgeriesmentioning

confidence: 99%

“…Trabeculectomy is the second most common glaucoma surgery following MIGS 1,2. The exact rate of infection after trabeculectomy is unknown; however, within the literature it ranges from 0.12% to 7.5% (Table 1).…”

Section: Infection In Glaucoma Surgeriesmentioning

confidence: 99%

“…Trabeculectomy is the second most common glaucoma surgery following MIGS. 1,2 The exact rate of infection after trabeculectomy is 126 ' Marando et al…”

Section: Rate Of Infection After Trabeculectomymentioning

confidence: 99%

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Intracameral Antibiotics and Glaucoma Surgery

Marando¹,

Neeson²,

Valle³

2022

International Ophthalmology Clinics

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surgery. 21 Despite these statistics, there is no consensus in the glaucoma community regarding IC antibiotic prophylaxis. ' Infection in Glaucoma Surgeries Timing of Infection IC antibiotics only have utility in preventing acute postoperative endophthalmitis. Under ideal conditions, IC antibiotics maintain a minimum inhibitory concentration for up to ∼30 hours in the anterior chamber (AC). 22 In the literature, acute infections are defined as occurring <4 to 6 weeks following surgery, whereas late infections occur > 6 weeks postoperatively. Late infections are more common than acute infections following trabeculectomy 23 and are often associated with bleb leaks. 24,25 In one study, only 15% (10/68) of cases of bleb-associated endophthalmitis (BAE) occurred within 1 month of surgery. 26 Late infections are also more common than acute infections following GDI surgery and are often associated with late tube exposures. 27,28 Since MIGS are relatively new, and the devices vary, it is unclear whether endophthalmitis will more often be acute (like after traditional cataract surgery) or late (like after traditional glaucoma surgery). This will probably vary based on whether a conjunctival bleb is formed, like in the case of the XEN Gel Stent (XGS) (Allergan, Abbvie Company, Irvine, CA, USA), and whether corneal incisions are made, which can act as a gateway for periocular bacteria in the immediate postoperative period. Even though late infections tend to be common, acute infections still confer significant morbidity for glaucoma patients.In fact, acute postoperative endophthalmitis occurs 3 times as often following glaucoma surgery than cataract surgery according to data from the Intelligent Research in Sight (IRIS) registry from 2013 to 2017. Before the widespread adoption of IC antibiotics for cataract surgery, the rate of acute endophthalmitis was 0.08% for cataract surgery and 0.12% for glaucoma filtering surgeries. 29 After evidence supporting IC antibiotics in cataract surgery emerged, the rate of acute endophthalmitis halved to 0.04% following cataract surgery alone, but remained at 0.12% following cataract surgery combined with glaucoma surgery. This may be because IC antibiotics have not been studied in the setting of glaucoma surgery, though this has yet to be determined. 21 Since, theoretically, only acute infections are prevented by the use of IC antibiotics, Table 1 summarizes the estimated incidence of overall and acute infection for each of the major glaucoma surgeries. Rate of Infection After TrabeculectomyTrabeculectomy is the second most common glaucoma surgery following MIGS. 1,2 The exact rate of infection after trabeculectomy is 126 ' Marando et al

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Section: Discussionmentioning

confidence: 99%

Section: Infection In Glaucoma Surgeriesmentioning

confidence: 99%

Section: Infection In Glaucoma Surgeriesmentioning

confidence: 99%

“…Trabeculectomy is the second most common glaucoma surgery following MIGS. 1,2 The exact rate of infection after trabeculectomy is 126 ' Marando et al…”

Section: Rate Of Infection After Trabeculectomymentioning

confidence: 99%

See 2 more Smart Citations

Intracameral Antibiotics and Glaucoma Surgery

Marando¹,

Neeson²,

Valle³

2022

International Ophthalmology Clinics

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show abstract

“…Of these surgeries, 13.1% were trabeculectomies, 11.4% were glaucoma drainage implants (GDIs), and 75.5% were MIGS. 2 Additionally, Centers for Medicare Services (CMS) collected data from all glaucoma surgeries performed in the US for Medicare beneficiaries from 2008 through 2016. 3 These data show a dramatic influx of MIGS procedures from 2012 to 2016, increasing by 426%.…”

Section: Introductionmentioning

confidence: 99%

Microinvasive Glaucoma Surgery: An Evidence-Based Review

Birnbaum

Neeson

Valle

2021

Seminars in Ophthalmology

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Purpose: Interest in micro-invasive glaucoma surgery (MIGS) has exploded over the last 8 years with an increase in MIGS procedures of at least 400% in the United States, according to Medicare data. MIGS is an umbrella term that can cover many different types of surgeries. This review focuses on peer-reviewed evidence for Trabectome ® , iStent inject ® , Kahook Dual Blade ® , XEN ® Gel Stent, and Hydrus ® . Methods: We present key recent studies evaluating the efficacy and safety of MIGS in various types of glaucoma patients with different stages of disease. Conclusion: We conclude that MIGS is generally safe and efficacious, although only some MIGS have been studied through randomized clinical trials. When comparing and contrasting the different MIGS procedures, large prospective studies are not yet the norm. High-quality large prospective studies involving MIGS will be an important next step as ophthalmologists decide how to incorporate MIGS into their surgical armamentarium.

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Geographic Distribution of US Ophthalmic Surgical Subspecialists

Ahmed,

Ali,

Dun

et al. 2025

JAMA Ophthalmol

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ImportanceWhile urban counties maintain higher densities of ophthalmologists than rural counties, the geographic distribution of ophthalmic surgical subspecialists has not yet been elucidated. A potential workforce discrepancy may impact the burden of care faced by rural surgeons.ObjectiveTo assess the geographic distribution of the ophthalmic subspecialist surgeon workforce and evaluate factors associated with practicing in rural areas.Design, Setting, and ParticipantsThis cross-sectional population-based study of Medicare patients and surgeons performing subspecialized procedures took place from 2012 through 2022. Medicare Fee-for-Service claims were analyzed in 2023 for patients 65 years or older who underwent subspecialized ophthalmic procedures between 2012 and 2022 using Current Procedural Terminology codes (n = 1 619 043). Surgeons were defined as a subspecialist based on Current Procedural Terminology codes, indicating performance of at least 1 subspecialty procedure from the following subspecialties: cornea, glaucoma, oculoplastic, retina, or strabismus (n = 13 526).Main outcomes and measuresThe primary outcome was the population density of practice for subspecialist surgeons and residence for patients (rural or urban). The secondary outcomes were the characteristics associated with rural practice.ResultsAmong 13 526 ophthalmic surgical subspecialists, 9823 were male (72.6%), 3235 were female (26.8%), and 4484 (33.2%) practiced in the South. There were 2540 cornea subspecialists (18.5%), 3676 glaucoma subspecialists (26.8%), 1951 oculoplastic subspecialists (14.2%), 4123 retina subspecialists (30.0%), and 1236 strabismus subspecialists (9.0%). Across subspecialties, a higher proportion of patients (17.4%; 95% CI, 16.9%-17.9%) resided in rural areas relative to surgeons (5.6%; 95% CI, 5.3%-5.9%) with differences ranging from 6.2% to 14.8% across subspecialities. Female surgeons (adjusted odds ratio [aOR], 0.63; 95% CI, 0.51-0.79; P &lt; .001), surgeons in the Northeast (aOR, 0.62; 95% CI, 0.48-0.78; P &lt; .001), surgeons in the West (aOR, 0.63; 95% CI, 0.50-0.79; P &lt; .001), and recent graduates relative to those who graduated 11 to 20 years ago (aOR, 1.66; 95% CI, 1.25-2.21; P &lt; .001), 21 to 30 years ago (aOR, 1.83; 95% CI, 1.38-2.42; P &lt; .001), or 31 years ago or longer (aOR, 1.43; 95% CI, 1.08-1.90; P = .013), were less likely to practice rurally.Conclusions and RelevanceThis cross-sectional study between 2012 and 2022 identified higher proportions of rural patients compared with rural surgeons. Percentages of rural surgeons declined over time, with female surgeons and recent medical school graduates less likely to practice rurally. This suggests a disparity in the number of rural subspecialist surgeons available to serve rural patients.

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<p>GlaucoMap – Distribution of Glaucoma Surgical Procedures in the United States</p>

Cited by 31 publications

References 23 publications

Intracameral Antibiotics and Glaucoma Surgery

Intracameral Antibiotics and Glaucoma Surgery

Microinvasive Glaucoma Surgery: An Evidence-Based Review

Geographic Distribution of US Ophthalmic Surgical Subspecialists

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