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Thomas J Wubben, Nidhi Talwar, Taylor Blachley, Thomas Gardner, Mark W Johnson, Paul P Lee, Joshua D Stein; Rates of Vitrectomy Among Enrollees in a United States Managed Care Plan, 2001-2012. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1400.
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In recent years, there have been advances in pharmacological treatment options for many retinal diseases, improvements in imaging technology, and improved surgical techniques. Further, better care of diabetes and its complications have reduced overall mortality and the risk of visual impairment. The purpose of this study is to assess whether such advances have impacted rates of vitrectomy surgery over the past decade.
Claims data from a managed-care network were analyzed on all patients ≥ 21 years old at plan entry between 2001 and 2012. Enrollees who underwent ≥1 pars plana vitrectomy (CPT codes 67036, 67108, 67038, 65260, 67039, 65265, 67040, 67299, 66990, 66850) were identified. Rates of vitrectomy per 1000 enrollees were computed each year from 2001-2012 for the entire group and separately for patients with diabetes mellitus.
During the 12 year period examined, 39,143 vitrectomies on 36,616 enrollees were performed. The average age of those undergoing vitrectomy was 55 ± 15.4 years and the majority were white (79.1%) and male (56.5%). Overall vitrectomy rates increased 17% from 2001 to 2005, peaking at 1.50 per 1000 patients. From 2005 to 2010 vitrectomy rates decreased by 39% such that the rate was 0.91 per 1000 patients in 2010. The rate of vitrectomy among persons with diabetes substantially decreased by 61% from 2002 (5.19 per 1000 patients) to 2012 (2.01 per 1000 patients). The most common indications for vitrectomy were retinal detachment, macular hole/pucker, disorders of the vitreous, and diabetic retinopathy.
There was a substantial decline in utilization of pars plana vitrectomy in this large managed-care network over the course of the past decade. This trend was observed for the overall sample as well as for the subset of enrollees with diabetes. These changes may be explained in part by advances in diabetes care.
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