Abstract
Purpose :
This study evaluated trends in the volume of oculoplastic procedures in the United States from 2000 to 2019.
Methods :
We conducted a retrospective insurance claims-based analysis of fee-for-service Medicare beneficiaries using Medicare Part B national summary data files. These files were analyzed using Current Procedural Terminology (CPT) codes to determine the number of oculoplastic procedures performed annually.
Results :
Overall, there was a 45% increase in oculoplastic procedure volume from 807,590 procedures in 2000 to 1,168,243 procedures in 2019. Procedure volume changed substantially for: (1) procedures performed on the nasolacrimal drainage system, (2) blepharoplasties and blepharoptosis repair, and (3) entropion and ectropion repairs. (1) Procedures on the nasolacrimal drainage system had the greatest change in volume. Closure of lacrimal puncta via punctal plugs had the greatest absolute increase from 223,348 to 428,396 procedures, a 92% increase. While other methods for closure by thermocauterization, ligation, or laser surgery decreased 51% from 17,293 to 8,478 procedures. Procedures to probe the nasolacrimal ducts via insertion of tubes or stents increased 159% from 4,404 to 11,405 procedures, while probing without the use of stents decreased 12% from 21,793 to 19,179 procedures. (2) The next greatest increase was due to blepharoplasties and blepharoptosis repair. Blepharoplasties increased 287% from 30,443 to 117,760 procedures. Blepharoptosis repairs also increased going from 52,320 to 86,000 procedures largely due to greater use of the external levator resection method which increased 56% from 44,088 to 68,847 procedures. (3) There were also notable changes in trends of entropion and ectropion repairs. Entropion repairs decreased from 26,143 to 22,690, while ectropion repairs increased from 32,312 to 37,916. For entropion repair, the lateral tarsal strip (LTS) and capsulopalpebral fascia repair (CPF) methods increased from being used in 50% to 72% of these repairs as other methods (i.e. thermocauterization, excision tarsal wedge) decreased. There was a similar trend in ectropion repair, as the LTS and CPF methods increased from 74% to 87% of these procedures between 2000 and 2019.
Conclusions :
The landscape of oculoplastic procedures has changed substantially between 2000 and 2019, owing to the adoption of newer surgical methods and technology.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.