July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Choice of Primary Rhegmatogenous Retinal Detachment Repair Method among Commercially-insured Patients, 2003-2016
Author Affiliations & Notes
  • Mary-Grace Reeves
    Stanford University School of Medicine, Stanford, California, United States
  • Suzann Pershing
    Department of Ophthalmology, Stanford University School of Medicine, Byers Eye Institute, Stanford, California, United States
    Veterans Affairs Palo Alto Health Care System, Palo Alto, California, United States
  • Armin Afshar
    Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States
  • Footnotes
    Commercial Relationships   Mary-Grace Reeves, None; Suzann Pershing, None; Armin Afshar, None
  • Footnotes
    Support  Stanford MedScholars, Research to Prevent Blindness, Inc., National Eye Institute (P30-EY026877)
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 4240. doi:
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    • Get Citation

      Mary-Grace Reeves, Suzann Pershing, Armin Afshar; Choice of Primary Rhegmatogenous Retinal Detachment Repair Method among Commercially-insured Patients, 2003-2016. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4240.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To examine trends in primary rhegmatogenous retinal detachment (RRD) repair method over time and assess the effect of patient characteristics on choice of primary repair method.

Methods : We evaluated patients with incident RRD using administrative claims from a nationwide managed care network (Clinformatics DataMart) filed between 2003 and 2016. We limited the data set to patients continuously enrolled for at least two years, and excluded patients with preexisting ocular conditions that might influence surgical repair and success rates, as well as patients who received an RRD diagnosis or underwent a repair procedure during a one-year lookback period. We calculated annual volume of new RRD diagnoses and trends in proportional utilization of different repair techniques over time. Multivariable logistic regression models were used to assess the effect of patient characteristics on primary repair method.

Results : A total of 59,107 patients were diagnosed with incident RRD between 2003 and 2006, with a mean of 4,221 diagnosed annually. Ocular comorbidities included myopia (5.1%), pseudophakia (33.9%), vitreous hemorrhage (16.9%), lattice degeneration (16.0%), and diabetes (29.2%). Pars plana vitrectomy was the most common primary repair method (Figure 1). 12.2% of patients required reoperation within 90 days of their primary procedure. Primary vitrectomy was more likely among patients with pseudophakia (OR 2.78; 95%CI 2.67-3.04), vitreous hemorrhage (OR 2.90; 95%CI 2.77-3.04), lattice degeneration (OR 1.30; 95%CI 1.24-1.37), or diabetes (OR 1.10; 95%CI 1.05-1.15). Primary scleral buckle was associated with lattice degeneration (OR 1.91; 95%CI 1.76-2.07) or myopia (OR 1.14; 95%CI 0.99-1.30). Vitreous hemorrhage and lattice degeneration were associated with higher odds of primary laser or cryotherapy. Myopia (OR 0.87; 95%CI 0.74-1.03) and pseudophakia (OR 0.90; 95%CI 0.83-0.98) were associated with lower odds of primary pneumatic retinopexy. While age was not associated with procedure selection, patients with a higher Charlson index most often underwent vitrectomy or did not receive a repair procedure.

Conclusions : Based on national insurance claims for 59,107 RRD patients, pars plana vitrectomy remains the most common repair procedure from 2004-2016. Type of repair procedure appears associated with ocular health as well as general health index.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

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