Proportion of Glaucoma Types and Surgeries Among Young, Pre-Old, Old, and Oldest-Old Age Groups or Different Sex Groups

Abstract

Background We report the real-world distribution of glaucoma types and glaucoma surgeries in each age or sex group in our department. Methods The department database of Matsue Red Cross Hospital, a tertiary care hospital, for eyes surgically treated to manage glaucoma between April 2014 and March 2018 was searched. Patient age, sex, disease type, and surgical procedure were collected from the database. The age was stratified by ≤64 years (young), 65–74 years (pre-old), 75–89 years (old), and ≥90 years (oldest-old or super-old). Results In the database, 2036 consecutive surgeries (70.3 ± 14.4 years; 1015 males) were identified. Among all subjects, primary open-angle glaucoma (POAG) (42.7%) was the most frequent identifiable glaucoma type followed by primary angle-closure disease (PACD) (18.8%) and exfoliation glaucoma (17.9%). The glaucoma types differed significantly among the age groups ( P < 0.0001); POAG was the most frequent type of glaucoma in young and pre-old groups, while PACD and exfoliation glaucoma were the most frequent glaucoma types in the oldest-old group. Among all subjects, trabeculotomy or other goniotomy/gonio-bypass surgery (41.7%) was the most frequent glaucoma surgery followed by long-tube shunt (22.1%) and trabeculectomy (16.2%). The glaucoma surgeries performed differed significantly among the age groups ( P < 0.0001). The frequency of trabeculectomy was the highest in the young group (27.8%), trabeculotomy was the highest in the pre-old (42.6%) and old (46.6%) groups, and long tube shunt (41.3%) and cataract extraction + goniosynechialysis (32.6%) were the highest in the oldest-old group. The glaucoma type ( P < 0.0001) and surgeries performed ( P < 0.0001) differed significantly between sex groups; the rates of PACD and cataract extraction + goniosynechialysis were remarkably higher in female than male group. Conclusion The types of glaucoma and required glaucoma surgeries differ among the different age groups and sexes. Primary angle-closure disease and exfoliation glaucoma are the major glaucoma types in the old and oldest-old age groups.

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

“…Because of the increase in the number of glaucoma patients due to an increase in the aged population [4], and because of the advent of new techniques, devices, and equipment that provides alternative treatments other than medication [5,6], the clinical indication of laser and other surgery should have changed dramatically in the past decade [7,8]. Accordingly, to understand the current status of glaucoma surgery, an updated analysis using the appropriate database was required.…”