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P.P. Lee, L. Van Scoyoc, F. Sloan; Endophthalmitis After Trabeculectomy . Invest. Ophthalmol. Vis. Sci. 2005;46(13):92.
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Purpose:To assess the longitudinal risk of endophthalmitis after trabeculectomy surgery in a nationally representative cohort of patients aged 65 and older. Methods: Individuals aged 65 and older enrolled in the National Long–Term Care Survey (NLTCS) in 1991 with linked Medicare database claims (all datafiles) who had trabeculectomy surgery (CPT 66170 and 66172) between 1991 and 1997 were analyzed for a subsequent claim diagnosis of endophthalmitis (ICD codes 360.0, 360.00 to 360.04 inclusive) through 1999. The NLTCS sample in 1991 consisted of 26,651 individuals aged 65 and older and was nationally representative at that time; the NLTCS is periodically re–balanced to reflect national representation. Patients were limited to one event of endophthalmitis in each year for the purposes of the analysis, to adjust for multiple claims by multiple providers seen for the management of the condition. Individuals who survived less than 6 months or joined an HMO for more than 6 months in a a calendar year were excluded from analysis in that year. Results: Of 360 total trabeculectomy surgeries captured in the Medicare claims for sample NLTCS enrollees, there were 8 diagnoses of endophthalmitis. Of the 43 claims of trabeculectomy with scarring (and thus likely use of antimetabolites – 66172), there was 1 endophthalmitis diagnosed within 2 years of surgery. Overall, cases occurred up to seven years after surgery, though with a tendency for the first 3 years following surgery. Conclusions: Endophthalmitis following trabeculectomy among a nationally representative sample of patients may differ to some degree from results seen from single referral centers. However, Conclusions: are limited by potential coding biases and a smaller sample size for the use of antimetabolites with trabeculectomy surgery. Nevertheless, this technique may be a useful method of monitoring complications of treatment in the community setting on a national level.
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