Abstract
Purpose :
To compare the odds of glaucoma surgery in minority racial/ethnic groups against that of white patients in the American Academy of Ophthalmology (AAO) Intelligent Research in Sight (IRIS) Registry database.
Methods :
This was a cross-sectional study using 2015-2017 IRIS Registry public use data of glaucoma patients from over 3,000 practices across the United States. The outcome of interest was three-year prevalence of glaucoma surgery by type, including incisional surgery (IS) (trabeculectomy, tube shunts), minimally invasive glaucoma surgery (MIGS) (canaloplasty, trabecular/suprachoroidal bypass, transscleral cyclophotocoagulation), and laser surgery (LS) (laser trabeculoplasty). The primary exposure was race/ethnicity, including American Indian/Alaska Native (AI/AN), Asian, Black, Latino, Multi, Native Hawaiian/Pacific Islander (NH/PI), white, and unknown. Logistic regression modeling was performed to estimate odds of IS, MIGS, and LS by racial/ethnic group, controlling for age, sex, insurance type, geographic region, and glaucoma severity.
Results :
The study sample included a total of 7,566,572 unique patients, of whom 74,028 (0.98%) received IS, 119,410 (1.58%) MIGS, 236,902 (3.13%) LS, and 7,172,833 (94.80%) received no surgery. Racial/ethnic groups with decreased odds of all glaucoma surgery types compared to white patients included Asians (IS odds ratio [OR]: 0.80, 95% confidence interval [95% CI]: 0.76-0.84; MIGS OR: 0.79, 95% CI: 0.76-0.82, LI OR: 0.88, 95% CI: 0.81-0.95), Latinos (IS OR: 0.97, 95% CI: 0.94-0.99; MIGS OR: 0.92, 95% CI: 0.90-0.94; LS OR: 0.95, 95% CI: 0.94-0.97), NH/PI (IS OR: 0.52, 95% CI: 0.40-0.69; MIGS OR: 0.66, 95% CI: 0.55-0.80; LS OR: 0.75, 95% CI: 0.66-0.86), and unknown race (IS OR: 0.65, 95% CI: 0.64-0.67; MIGS OR: 0.81, 95% CI: 0.79-0.82; LS OR: 0.73, 95% CI: 0.72-0.75). Compared to white patients, Black patients had increased odds of IS (OR: 1.26, 95% CI: 1.23-1.28), decreased odds of LS (OR: 0.96, 95% CI: 0.95-0.98), and no difference in odds of MIGS (OR: 1.01, 95% CI: 0.99-1.03).
Conclusions :
In the 2015-2017 AAO IRIS Registry sample, most minority racial/ethnic groups (Asians, Latinos, NH/PI, unknown race) were found to have decreased odds of all glaucoma surgery types when compared to white patients, after adjusting for covariates. Additional population-based studies are necessary to further examine differences in rates of glaucoma surgery across racial/ethnic groups.
This is a 2021 ARVO Annual Meeting abstract.