Reduction in admissions of patients with acute primary angle closure occurring in conjunction with a rise in cataract surgery in Taiwan

Abstract

ABSTRACT.Purpose: Using 8 year nationwide administrative data, this study sets out to investigate the relationship between the total number of cataract operations undertaken in Taiwan and admissions for acute primary angle closure (APAC). Methods: Monthly cataract surgery and APAC admission rates, per 100 000 of the population, were provided by 1997-2004 inpatient and outpatient data obtained from the Taiwanese National Health Insurance Research Database. The 3814 cases of APAC and 503 687 patients who had undergone cataract operations were categorized by age groups (40-49, 50-59, 60-69 and ‡70 years) and by gender. Spearman rank correlation coefficients were used to examine the direction and strength of the relationships. Results: Throughout the study period, the admissions for APAC showed a steady decline from 630 cases in 1997 to 351 cases in 2004, while the number of cataract operations revealed a gradual increase from 26 600 in 1997 to 77 924 in 2004. The Spearman rank correlation coefficients showed significant inverse relationships between monthly APAC admission rates and monthly cataract operation rates for the total group (r = )0.407, P < 0.001), males (r = )0.330, P < 0.001), females (r = )0.444, P < 0.001), 40-49 year olds (r = )0.335, P < 0.001), 50-59 year olds (r = )0.497, P < 0.001) and 60-69 year olds (r = )0.417, P < 0.001). No significant inverse relationship was observed for the ‡70 age group. Conclusion: Significant inverse relationships were noted between the monthly APAC admission rates and the monthly cataract operation rates. We recommend that data should be collected from other regions and ethnic groups to determine the inter-relationships.

The Prevalence and the Incidence of Diagnosed Open-Angle Glaucoma and Diagnosed Angle-Closure Glaucoma: Changes From 2001 to 2010

“…The decreasing trend in ACG incidence might be related to the high prevalence of myopia and the increasing number of cataract surgeries performed in Taiwan. 19,22,23 Both myopia and cataract surgery result in an increasing depth of the anterior chamber, 24,25 thereby leading to a decrease in the incidence of ACG.…”

Increased Risk of Acute Angle Closure in Retinitis Pigmentosa: A Population-Based Case-Control Study

“…There were no differences in age, gender, or healthcare costs between the sampled group and all the enrollees [12]. The accuracy of the claims data of the NHIRD was properly monitored and validated [13], [14], and hundreds of studies based on this dataset have been published in peer-reviewed journals, including ophthalmology-related studies and those focused on angle closure glaucoma or retinitis pigmentosa [15]–[17].…”

Trends in Glaucoma Medication Expenditures under Universal Health Coverage: A National Population-Based Longitudinal Survey in Taiwan

“…Women are at higher risk of ACG [18] that can be treated with laser iridotomy or cataract surgery rather than glaucoma medications. Cataract surgery is readily available in Taiwan and the procedure reduces the likelihood of developing the disease [13, 19]. …”

“…Even though most people in Taiwan are Chinese in origin and have a higher prevalence of ACG [2, 17], there has been a decreasing trend in the application of cholinergic agonists, which may be offset by the increased availability of other drugs like PGAs and the increase in frequency of cataract surgery in Taiwan [13, 23]. The trend in increasing expenditures for fixed combinations of medications during the period of study can be attributed to patients' preference, because the fixed combinations improve medical adherence and reduce eye discomfort [6].…”

“…Claim reimbursement data from patients since 1999 are provided to researchers in an electronically encrypted form. Data contained in the LHID2000 are randomly selected from one million subjects from the NHIRD and are made available for research purposes [13]. Data from the LHID2000 used in this study included patient identification numbers, gender and age, monthly salary, occupation type, diagnostic data, antiglaucoma drug codes, and surgery codes.…”