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Recent trends in glaucoma surgery: a nationwide database study in Japan, 2011–2019

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Abstract

Purpose

To clarify recent trends in glaucoma surgery in Japan, including minimally invasive glaucoma surgery.

Study design

Retrospective cohort study.

Methods

We used the Diagnostic Procedure Combination database, a nationwide administrative database in Japan. Patients who underwent glaucoma-related procedures were included. We calculated the number of surgeries stratified by procedures and age categories. We also investigated the number of glaucoma-related procedures in combination with cataract surgery.

Results

From fiscal years 2011 to 2019, we identified 134,331 glaucoma-related procedures at 720 hospitals. The total number of glaucoma-related procedures increased by 215% from 6516 in 2011 to 20,569 in 2019. The numbers of filtering surgeries, trabeculotomies, and glaucoma drainage devices with plates [GDD(p +)] procedures significantly increased (P = 0.002, 0.002, and 0.006, respectively), whereas the number of cyclocryotherapy procedures significantly decreased (P = 0.002). The number of iStent procedures increased by 49% from 371 in 2018 to 551 in 2019. The ≥ 65 year age group accounted for > 80% of the iStent procedures. In the 0 to 14 year age group, trabeculotomy accounted for about 70% of the procedures, and the GDD(p +) procedure became the second most common procedure after trabeculotomy because of the decrease in filtering surgeries. Among combination surgeries, trabeculotomy was most frequently performed. The proportion of combination surgery increased, especially in trabeculotomy.

Conclusions

The total number of glaucoma-related procedures increased throughout the observation period. Before 2017 filtering surgery was the most common procedure, whereas trabeculotomy was most common after 2018. The proportion of trabeculotomies performed in combination with cataract surgery continuously increased.

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Acknowledgements

This work was supported by grants from the Ministry of Health, Labour and Welfare, Japan (21AA2007 and 20AA2005) and the Ministry of Education, Culture, Sports, Science and Technology, Japan (20H03907). The manuscript has been edited carefully by a native English-speaking professional editor from Convention Linkage, Inc. (https://www.c-linkage.co.jp).

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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

    Asahi Fujita, Yohei Hashimoto & Makoto Aihara

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

    Asahi Fujita, Yohei Hashimoto, Hiroki Matsui & Hideo Yasunaga

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  1. Asahi Fujita
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  2. Yohei Hashimoto
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Corresponding author

Correspondence to Asahi Fujita.

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Conflicts of interest

A. Fujita, None; Y. Hashimoto, None; H. Matsui, None; H. Yasunaga, None; M. Aihara, None.

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Corresponding Author: Asahi Fujita

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Fujita, A., Hashimoto, Y., Matsui, H. et al. Recent trends in glaucoma surgery: a nationwide database study in Japan, 2011–2019. Jpn J Ophthalmol 66, 183–192 (2022). https://doi.org/10.1007/s10384-021-00898-6

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  • DOI: https://doi.org/10.1007/s10384-021-00898-6

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