Abstract
Purpose :
The National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB), provided by the Ministry of Health and Welfare, contains all the insurance claims of the Japanese national healthcare system. Using the NDB open data, the number of glaucoma surgeries were aggregated to know the trends of glaucoma surgical procedures performed in Japan.
Methods :
The number of glaucoma surgeries billed by insurance was extracted from the NDB for FY2014 and FY2020, and compared between the two years. The surgeries were aggregated by code K268-1 for iridectomy, K268-2 for angle-surgery, K268-3 and K268-4 for filtration surgery, K268-5 for tube shunt surgery, K271 and K272 for ciliary coagulation, K270 for iris laser, and K273 for gonio-laser. The surgeries were aggregated also by codes K268-1, K268-2, K268-3, K268-4, K268-5, and K272 for non-laser surgery (i.e., incisional surgeries and cyclocryotherapy), and by K270, K271, and K273 for laser surgery. To calculate the per 100,000 capita glaucoma surgeries, the population number of 47 prefectures from national census in 2020 provided by the Statistics Bureau of Japan was used.
Results :
Total number of non-laser, laser, and total procedures billed were 33,340, 54,679, and 88,019 in FY 2014 and 60,108, 60,547, and 120,655 in FY 2020, representing increases of 180%, 111%, and 137%, respectively. Among non-laser surgeries, the most frequent procedure was filtration surgery in FY 2014, but was angle-surgery in FY 2020. Among laser surgery, gonio-laser (i.e., laser trabeculoplasty) was the most frequent in both years. Among the non-laser surgeries, tube shunt surgery (383%) and angle-surgery (326%) increased, while filtration surgery (100%) remained unchanged and iridectomy (75%) decreased. Among the laser surgeries, ciliary coagulation (489%) and gonio-laser (225%) increased, while iridotomy (77%) decreased. The rate of increase in non-laser surgeries was higher in the elderly, while the rate of increase in laser surgery tended to be higher in the younger population. In FY2020, 47.6 non-laser, 48.0 laser, and in total 95.6 glaucoma surgeries were performed per 100,000 persons in Japan.
Conclusions :
Successively reported novel glaucoma surgeries including intraocular ab interno angle-surgeries, selective laser trabeculoplasty, and micropulse cyclophotocoagulation might be related to the increase in the number of glaucoma surgeries during the study period.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.