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R. Rachmiel, M. Chipman, P. Gouws, G. Trope, Y. Buys; Effect of Medical Therapy on Glaucoma Filtration Surgery Rates in Ontario . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3654.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To analyze trends of glaucoma filtration surgery and to correlate this with the introduction of newer medical therapies for glaucoma. Methods: The number of filtration surgeries performed in Ontario, Canada, from April 1992 to March 2004 were obtained from the Ontario Health Insurance Program. The Ontario population distribution by age was obtained from the Statistics Canada data for the same time period. The estimated prevalence of primary open angle glaucoma (POAG) was calculated to provide the number of filtration surgeries per 1000 patients at risk for POAG. For comparison identical calculations were done for cataract surgeries. Results: The total number of trabeculectomies increased from 1735 in 1992 to a maximum of 2647 in 1997 (52.6%) and then remained stable for the remainder of the study period. The estimated prevalence of POAG increased from 51727 to 69154 (33.7%; 2.4 % increase per year ) in the same time period. The number of trabeculectomies per 1000 patients with POAG increased from 33.54 in 1992 to maximum of 46.2 in 1997 (37.7%; 6.6% increase per year) and then steadily decreased to 38.2 in 2004 (17%; 2.7% decrease per year ). New medications were introduced in Ontario as follows: Trusopt – Dec 1996, Xalatan – June 1997, Alphagan – Nov 1997, Cosopt – May 1999, Travatan – Nov 2001, Lumigan – May 2002 and Combigan – Dec 2003. In comparison the total number of cataract surgeries increased from 44 943 in 1992 to 100 751 in 2003 (124%). The estimated prevalence of cataract increased from 695 299 to 920 028 (32.3%) in the same time period. The number of cataract surgeries per 1000 patients with cataract increased from 64.6 in 1992 to 109.4 in 2003 (69.3%, 6.0% increase per year). Conclusions: There has been a substantial decrease in the number of glaucoma surgeries for patients with glaucoma in Ontario, Canada, coinciding with the introduction of newer medications in 1997.
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