The impact of new drugs on management of glaucoma in Scotland: observational study

Hospital Episode Statistics and changing trends in glaucoma surgery

“…It has been recognised for some years that the number of trabeculectomies being performed [1][2][3][4][5] has been steadily decreasing and this is shown by the HES data. This is in contrast to the exponential increase in use of prostaglandins over the last 8 years, which might support the suggestion of a causal relationship between the two observations.…”

“…[1][2][3][4][5] This has been attributed by some to the introduction of a range of new medications for lowering intraocular pressure (IOP) but we hypothesise that there may have been additional influencesFin particular that the increasing cataract surgical rate (which has nearly doubled in the last few years) may have had an impact on glaucoma surgery. This may be restricted to acute and chronic angle closure disease but may also influence open angle disease.…”

South-East Scotland trabeculectomy survey

“…The medical treatment of glaucoma has seen a steady increase in the use of new and powerful intraocular pressure (IOP)-reducing topical agents. 4 As a result, over the same period there has been a steady decline in the number of trabeculectomies being performed. 4,5 This is occurring during a time when higher surgical trainees (HST) are expected to perform a set number of glaucoma procedures.…”

“…4 As a result, over the same period there has been a steady decline in the number of trabeculectomies being performed. 4,5 This is occurring during a time when higher surgical trainees (HST) are expected to perform a set number of glaucoma procedures. 6 The use of antimetabolites intraand postoperatively has increased considerably since 1996 with more aggressive postoperative management of the failed trabeculectomy bleb.…”

Prospective survey of adverse reactions to topical antiglaucoma medications in a hospital population

“…This is borne out by a significant decrease in the number of glaucoma filtration procedures performed (in spite of improved techniques), and by a dramatic rise in unit sales of ocular hypotensive agents. [1][2][3] One of the major contributory factors is likely to be the introduction of new topical therapies, including alpha-agonists, carbonic anhydrase inhibitors, and prostaglandin analogues. The efficacy of these drugs and their additive effect when used in combination has led to prolonged periods of medical treatment often comprising multiple agents.…”