Global rates of glaucoma surgery

Mansouri, Kaweh; Medeiros, Felipe A.; Weinreb, Robert N.

doi:10.1007/s00417-013-2464-7

Cited by 43 publications

(38 citation statements)

References 28 publications

(26 reference statements)

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“…However, trabeculectomy was the most commonly performed glaucoma surgery in France during this 10-year period. This is in agreement with a recent study reporting that trabeculectomy was the most frequently performed glaucoma surgery in 21 countries 13. Ciliary body destruction gained more acceptance among French ophthalmologists with a 73% increase over this observation period.…”

Section: Discussionsupporting

confidence: 92%

“…This huge difference may account for different treatment modalities available in a given region, the level of reimbursement for patients and may depend on the number of ophthalmologists in a given area. In this study, we observed a positive association between the number of operating room-based glaucoma procedures and the number of ophthalmologists only for the country's 14 regions, in agreement with a recent report 13. Even though all ophthalmologists do not perform surgery, at least in France, non-surgical colleagues refer their patients with glaucoma to glaucoma surgeons when a surgical procedure is needed.…”

Section: Discussionsupporting

confidence: 92%

“…It has already been mentioned that reporting glaucoma surgical procedures is not an easy task 13. In fact, each country has its own particularities for delivering glaucoma surgical care and there is a high discrepancy in glaucoma surgical rates in different parts of the world 15.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, each country has its own particularities for delivering glaucoma surgical care and there is a high discrepancy in glaucoma surgical rates in different parts of the world 15. A recent survey reported an overall glaucoma surgery rate (GSR) ranging from 7 to 500, given per million inhabitants 13. This huge difference may account for different treatment modalities available in a given region, the level of reimbursement for patients and may depend on the number of ophthalmologists in a given area.…”

Section: Discussionmentioning

confidence: 99%

“…15 However, when taking into account a standardised incidence, the difference for GSR between these two studies was much lower. Therefore, investigators should come to an agreement on how to report the GSR consistently, so that countries can be compared more easily 13. Another difference between countries lies in the types of surgery delivered to patients.…”

Section: Discussionmentioning

confidence: 99%

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Trends in operating room-based glaucoma procedures in France from 2005 to 2014: a nationwide study

et al. 2017

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Trends in operating room-based glaucoma procedures in France from 2005 to 2014: a nationwide study

et al. 2017

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The Pathophysiology and Treatment of Glaucoma

Weinreb

Aung

Medeiros

2014

JAMA

Self Cite

2,998

2,485

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IMPORTANCE Glaucoma is a worldwide leading cause of irreversible vision loss. Because it may be asymptomatic until a relatively late stage, diagnosis is frequently delayed. A general understanding of the disease pathophysiology, diagnosis, and treatment may assist primary care physicians in referring high-risk patients for comprehensive ophthalmologic examination and in more actively participating in the care of patients affected by this condition. OBJECTIVE To describe current evidence regarding the pathophysiology and treatment of open-angle glaucoma and angle-closure glaucoma. EVIDENCE REVIEW A literature search was conducted using MEDLINE, the Cochrane Library, and manuscript references for studies published in English between January 2000 and September 2013 on the topics open-angle glaucoma and angle-closure glaucoma. From the 4334 abstracts screened, 210 articles were selected that contained information on pathophysiology and treatment with relevance to primary care physicians. FINDINGS The glaucomas are a group of progressive optic neuropathies characterized by degeneration of retinal ganglion cells and resulting changes in the optic nerve head. Loss of ganglion cells is related to the level of intraocular pressure, but other factors may also play a role. Reduction of intraocular pressure is the only proven method to treat the disease. Although treatment is usually initiated with ocular hypotensive drops, laser trabeculoplasty and surgery may also be used to slow disease progression. CONCLUSIONS AND RELEVANCE Primary care physicians can play an important role in the diagnosis of glaucoma by referring patients with positive family history or with suspicious optic nerve head findings for complete ophthalmologic examination. They can improve treatment outcomes by reinforcing the importance of medication adherence and persistence and by recognizing adverse reactions from glaucoma medications and surgeries.

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Differences in Tertiary Glaucoma Care in the Veterans Affairs Health Care System

Lee

Pieters

et al. 2018

JAMA Ophthalmol

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IMPORTANCE Glaucoma is a common cause of visual impairment in the Veterans Affairs (VA) health care system, but to our knowledge, no data exist concerning tertiary glaucoma care (ie, laser and filtering surgery). OBJECTIVE To determine whether the rate of tertiary glaucoma care differs among veterans cared for through the 4 different eye care delivery models that are present in the VA: optometry-only clinics, ophthalmology-only clinics, clinics with optometry and ophthalmology functioning as a single integrated clinic with ophthalmology as the lead, and clinics with optometry and ophthalmology functioning as separate clinics. DESIGN, SETTING, AND PARTICIPANTS In this retrospective review of the Veterans Health Administration Support Service Center database, 490 926 veterans with a glaucoma-related diagnosis received care from 136 VA medical centers during fiscal year 2016. Demographic and baseline clinical factors, International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, and Current Procedural Terminology codes, and the rates of glaucoma surgery procedures were extracted from the database. The organizational structure of each VA eye clinic was obtained. Univariate and multivariate regression analyses were performed for log percent for laser peripheral iridotomy (LPI), laser trabeculoplasty (LTP), and filtering surgery. MAIN OUTCOMES AND MEASURES Rates of LPI, LTP, and filtering surgery. RESULTS Of the 490 926 veterans with a glaucoma-related diagnosis, 465 842 (94.9%) were male, 309 677 (63.1%) were white, and 203 243 (41.4%) were aged 65 to 74 years. The rate of LPI was 0.30%, 0.28%, 0.67%, and 0.69% in optometry-only clinics, ophthalmology-only clinics, integrated clinics, and separated clinics, respectively (P < .001). The rate of LTP was 0.31%, 1.06%, 0.93%, and 0.92% in care delivery models that included optometry-only clinics, ophthalmology-only clinics, integrated clinics, and separated clinics, respectively (P < .001). The rate of filtering surgery was 0.32%, 0.51%, 0.69%, and 0.60% in optometry-only clinics, ophthalmology-only clinics, integrated clinics, and separated clinics, respectively (P < .001). Multivariate regression analyses showed that these differences remained significantly different even after adjusting for potential confounders. CONCLUSIONS AND RELEVANCE Disparities exist in the use of tertiary glaucoma services within the VA, and different care delivery models may play a role. Outcomes of glaucoma care for the different models of eye care delivery were not analyzed in this study.

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Global rates of glaucoma surgery

Abstract: There is a paucity of data on rates of glaucoma surgery, particularly from developing countries. The new metric GSR may be useful for the allocation of healthcare resources, as well as for planning and monitoring public health interventions in glaucoma.

Cited by 43 publications

References 28 publications

Trends in operating room-based glaucoma procedures in France from 2005 to 2014: a nationwide study

Trends in operating room-based glaucoma procedures in France from 2005 to 2014: a nationwide study

The Pathophysiology and Treatment of Glaucoma

Differences in Tertiary Glaucoma Care in the Veterans Affairs Health Care System

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