Abstract
Purpose: :
We describe the changing pattern, time trends and geographical variation in rates of retinal detachment surgery in the England from 1963 to 2004.
Methods: :
Data was collected from Hospital Episode Statistics (DoH) 1989-2004, Hospital in-patient Enquiry from 1963-1986 and the Oxford Record Linkage Study (ORLS) from 1963 to 2003. Approval was obtained from the programme of research, NHS Central Office for Research Ethics Committees.
Results: :
We found that the rate of detachment procedures rose from 10/100,000 in 1963 to 32 /100,000 in 2004. Elective detachment procedures rose from 2.4/100,000 in 1968 to 8.8/100,000 in 2004. Emergency detachment procedures rose from 3/100,000 in 1963 to 9/100,000 in 2004. In 1975 the rate of vitrectomy detachment repair was 0.1/100,000. By 2004 this rose to 29.8/100,000. The rate of buckling procedures was 3.8/100,000 in 1968 rising to 12/100,000 in 1995 and declining to 6.6/100,000 in 2004. We also present atlas data of England showing the rate of retinal surgery for each local health authority, each strategic health authority and each government office region.
Conclusions: :
Vitrectomy for detachment repair has overtaken the buckle procedure in England. This suggests that some areas maybe 'over-serviced' whilst others maybe 'under-providing'. These trends have implications for patient care, financial implications for commissioning by PCT's and professional training in vitreo-retinal surgery.
Keywords: retina • vitreoretinal surgery • retinal detachment