Purpose:
a) to compare the time elapsed from diagnosis to surgery in two cohorts of residents in the Northern Italian County named Emilia Romagna (ER) who underwent trabeculectomy (TE) in the years 1997 and 2004; b) to measure the number of glaucoma surgical procedures performed in ER in the same years
Methods:
retrospective chart review. Records of patients who underwent TE (first procedure) in the years 1997 and 2004 respectively, were dissected out the data base of the University Eye Clinic of Parma which is located in ER. Year 1997 was chosen since prostaglandin analogues (PA) were registered in Italy at the end of that year. Then, we obtained from the Regional Health System registry the date each operated patient was previously registered with the code corresponding to the diagnosis of "open angle glaucoma". This diagnosis included either POAG or SOAG(s) like PEX and PG. Concurrently, the total number of first–time TEs performed in the whole ER during the same years was obtained
Results:
the records of n= 63 (1997) and n= 56 (2004) patients were obtained. Demographics are here listed in table 1. Time elapsing from diagnosis to surgery was 3.04 ±1.9 years (range 0.5–6) in the 1997 cohort and 6.5 ±4.1 years (range 0.5–13) in the 2004 cohort (unpaired samples Student t test, p = 0.00000036). The size of sample, together with the extent of the observed difference, is giving to the analysis a power= 95% and an alpha probability= 1%. Total number of first–time TE performed in ER decreased from n= 1767 in the year 1997 to n= 885 in the year 2004.
Conclusions:
a) first–time TE was more delayed in the year 2004 than in the year 1997 in our cohort of OAG patients; b) the vast majority of patients belonging to the 2004 cohort was receiving a treatment including a PA; c) the number of first–time TE was lower in the year 2004 than in 1997 in the whole Emilia Romagna; d) the availability of PA was paralleled by a increased time interval between diagnosis and surgery and by a decreased number of first–time glaucoma procedures in Northern Italy
Keywords: clinical (human) or epidemiologic studies: health care delivery/economics/manpower • intraocular pressure