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Recent trends in vitreoretinal surgery: a nationwide database study in Japan, 2010–2017

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

We clarified recent trends in vitreoretinal surgery in Japan, which is a rapidly aging country.

Study Design

Retrospective cohort study.

Methods

We used the Diagnostic Procedure Combination database (2010–2017), a national inpatient database in Japan. Patients undergoing vitreoretinal surgery were included. We measured the number of surgeries stratified by procedures, diagnoses, age categories, and combined cases of cataract surgery per fiscal year. We also considered changes in the Japanese population.

Results

From 2010 to 2017, the total number of vitreoretinal surgeries per fiscal year increased by 7.8% (from 36,988 to 39,873). Among the diagnoses categories, epiretinal membrane (ERM) increased by 71%, rhegmatogenous retinal detachment (RRD) with pars plana vitrectomy (PPV) by 50%, and macular hole (MH) by 12% throughout the observed period. Diabetic retinopathy (DR) decreased by 20%, RRD with scleral buckling (SB) by 40%, and vitreous hemorrhage (VH) by 10%. We observed remarkable increases in ERM among patients in their 60s and 70s, in MH in their 70s and 80s, and in RRD with PPV in their 50s and 60s. We observed remarkable decreases in RRD with SB in patients in their 20s–70s, in DR in their 60s, and in VH in their 60s and 70s. These findings did not change greatly when population changes were considered. All age groups from the 30 to 80s showed significant increases in the proportions of combined vitreoretinal and cataract surgery.

Conclusion

The total number of cases of vitreoretinal surgery per fiscal year increased throughout the period. The increases in ERM and RRD with PPV and the decreases in DR and RRD with SB were remarkable.

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Funding

This work was supported by grants from the Ministry of Health, Labour and Welfare, Japan (H30-Policy-Designated-004 and H29-ICT-General-004) and the Ministry of Education, Culture, Sports, Science and Technology, Japan (17H04141). The sponsor or funding organization had no role in the design or conduct of this research.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Yohei Hashimoto, Makoto Aihara, Muneyuki Takao & Ryo Obata

  2. Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Nobuaki Michihata

  3. Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan

    Yohei Hashimoto, Hiroki Matsui, Miho Ishimaru & Hideo Yasunaga

  4. Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School, Tokyo, Japan

    Kiyohide Fushimi

  5. Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan

    Miho Ishimaru

Authors
  1. Yohei Hashimoto
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  2. Nobuaki Michihata
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  3. Hiroki Matsui
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  5. Kiyohide Fushimi
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Corresponding author

Correspondence to Ryo Obata.

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Conflicts of interest

Y. Hashimoto, None; N. Michihata, None; H. Matsui, None; M. Ishimaru, None; K. Fushimi, None; H. Yasunaga, None; M. Aihara, None; M. Takao, None; R. Obata, None.

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Corresponding Author: Ryo Obata

Electronic supplementary material

Below is the link to the electronic supplementary material.

10384_2020_777_MOESM1_ESM.pdf

Online Resource 1. Searching terms for identifying indications for vitreoretinal surgery. *We used the Japanese equivalent for these search terms

10384_2020_777_MOESM2_ESM.pdf

Online Resource 2. Japanese population per fiscal year (unit: 1,000 people). Population in 1985 was used to calculate age-standardized rates of vitreoretinal surgeries. aAge categories 80–89 and 90– years are summed because the age category 90– does not exist in the Japanese 1985 model

10384_2020_777_MOESM3_ESM.pdf

Online Resource 3. Crude rates of vitreoretinal surgeries performed per 100,000 people per fiscal year. Japanese population per fiscal year (Online Resource 2) was used to calculate rates

10384_2020_777_MOESM4_ESM.pdf

Online Resource 4. Age-standardized rates of vitreoretinal surgeries performed per 100,000 people per fiscal year (Japanese 1985 model). Japanese population per fiscal year (Online Resource 2) was used to calculate rates

10384_2020_777_MOESM5_ESM.pdf

Online Resource 5. Rates of vitreoretinal surgery performed per 100,000 people per fiscal year for all diagnoses by age category. The value in each cell equals the annual number of surgeries divided by the population corresponding to the year and age category

Online Resource 6. Number of surgeries for epiretinal membrane (ERM) by age category

Online Resource 7. Number of surgeries for macular hole (MH) by age category

Online Resource 8. Number of surgeries for diabetic retinopathy (DR) by age category

Online Resource 9. Number of surgeries for vitreous hemorrhage (VH) by age category

10384_2020_777_MOESM10_ESM.pdf

Online Resource 10. Rates of vitreoretinal surgery performed per 100,000 people per fiscal year for rhegmatogenous retinal detachment (vitrectomy + buckling) by age category. The value in each cell equals the annual number of surgeries divided by the population corresponding to the year and age category

10384_2020_777_MOESM11_ESM.pdf

Online Resource 11. Rates of vitrectomy performed per 100,000 people per fiscal year for rhegmatogenous retinal detachment by age category. The value in each cell equals the annual number of surgeries divided by the population corresponding to the year and age category

10384_2020_777_MOESM12_ESM.pdf

Online Resource 12. Rates of scleral buckling procedures performed per 100,000 people per fiscal year for rhegmatogenous retinal detachment by age category. The value in each cell equals the annual number of surgeries divided by the population corresponding to the year and age category

10384_2020_777_MOESM13_ESM.pdf

Online Resource 13. Rates of vitreoretinal surgery performed per 100,000 people per fiscal year for epiretinal membrane by age category. The value in each cell equals the annual number of surgeries divided by the population corresponding to the year and age category

10384_2020_777_MOESM14_ESM.pdf

Online Resource 14. Rates of vitreoretinal surgery performed per 100,000 people per fiscal year for diabetic retinopathy by age category. The value in each cell equals the annual number of surgeries divided by the population corresponding to the year and age category

10384_2020_777_MOESM15_ESM.pdf

Online Resource 15. Rates of vitreoretinal surgery performed per 100,000 people per fiscal year for macular hole by age category. The value in each cell equals the annual number of surgeries divided by the population corresponding to the year and age category

10384_2020_777_MOESM16_ESM.pdf

Online Resource 16. Rates of vitreoretinal surgery performed per 100,000 people per fiscal year for vitreous hemorrhage by age category. The value in each cell equals the annual number of surgeries divided by the population corresponding to the year and age category

10384_2020_777_MOESM17_ESM.pdf

Online Resource 17. Crude rates of combined vitreoretinal surgery performed per 100,000 people per fiscal year. Japanese population per fiscal year (Online Resource 2) was used to calculate rates

10384_2020_777_MOESM18_ESM.pdf

Online Resource 18. Age-standardized rates of combined vitreoretinal surgery performed per 100,000 people per fiscal year (Japanese 1985 model). Japanese population per fiscal year (Online Resource 2) was used

10384_2020_777_MOESM19_ESM.pdf

Online Resource 19. Rates of combined vitreoretinal surgery performed per 100,000 people per fiscal year for all diagnoses by age category. The value in each cell equals the annual number of surgeries divided by the population corresponding to the year and age category

10384_2020_777_MOESM20_ESM.pdf

Online Resource 20. Number of vitreoretinal surgeries, including both inpatients and outpatients, from the NDB database, which covers the whole of Japan. Data are presented as number of surgeries. PPV = pars plana vitrectomy

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Hashimoto, Y., Michihata, N., Matsui, H. et al. Recent trends in vitreoretinal surgery: a nationwide database study in Japan, 2010–2017. Jpn J Ophthalmol 65, 54–62 (2021). https://doi.org/10.1007/s10384-020-00777-6

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  • DOI: https://doi.org/10.1007/s10384-020-00777-6

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