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

Abstract

Nationwide trends in glaucoma surgical procedures were assessed by using the NDB Open Data 2014 and 2020. In Japan, 33,340 non-laser, 54,569 laser, and 88,019 total glaucoma surgeries were performed in 2014. In 2020, 60,108 non-laser, 60,547 laser, and 120,655 total glaucoma surgeries were performed. The rates from 2014 to 2020 were 180%, 111%, and 137%, respectively. In each procedure, angle surgery (326%), tube shunt surgery (383%), ciliary coagulation (489%), and gonio-laser (225%) were remarkably increased, while iridectomy (75%) and iris laser (77%) decreased during the same period. An increase in laser surgery was seen in young age groups, namely, 55–59 years old and younger, while non-laser surgery was increased in old age groups, namely, 45–49 years old and older. In 2020, 47.6 non-laser, 48.0 laser, and 95.6 total glaucoma surgeries were performed per 100,000 persons. None of the vital statistics, including prefectural population, mean age, and rate of ≥65-year-old people, were significantly associated with the number of glaucoma surgeries. Glaucoma practice patterns changed each time a new device or procedure was introduced. The results of the current study reflected the use of new procedures, such as minimally invasive glaucoma surgery, tube shunt, selective laser trabeculoplasty, and micropulse cyclophotocoagulation.

Estimation of Topical Glaucoma Medication Over-Prescription and Its Associated Factors

“…Concurrently, there was a modest decline in the number of standard glaucoma surgeries, from 16,215 in 2013 to 13,701 in 2018 [ 27 ]. In Japan, in nationwide trends in glaucoma surgical procedures assessed by using the NDB Open Data, incisional and laser glaucoma surgeries increased 180% and 111%, respectively, from 2014 to 2020 [ 4 ]. In Germany, by analyzing the quality report of hospitals, the number of glaucoma procedures performed increased by 75% from 27,811 in 2006 to 48,794 in 2018 [ 28 ].…”

“…Elevated intraocular pressure (IOP) is a major risk factor for glaucoma. The only evidence-proven treatment for glaucoma is to lower IOP through medication, laser, or incisional surgery [ 3 , 4 ], although the medication applied topically is the mainstay of the treatment option in the majority of glaucoma patients [ 5 ]. Oral medications are frequently used in fields other than ophthalmology.…”