Hospital Episode Statistics and changing trends in glaucoma surgery.
BACKGROUND
A number of authors have documented the decrease in the rate of glaucoma drainage surgery, felt to be owing to increased medical therapy options. There has also been an increase in cataract extraction. The aim of this study was, using the NHS Hospital Episode Statistics (HES), to attempt to confirm these trends and to examine the possibility that these trends are not necessarily independent.


METHODS
The HES was accessed for the main glaucoma procedures between 1998 and 2004 and for cataract operations performed over the same time period. Diagnostic data were also extracted from the HES data for glaucoma. Figures for the changes in glaucoma medications were obtained from pharmaceutical data.


RESULTS
Over the period that the data are available, trabeculectomy numbers have reduced by 51%, laser trabeculoplasty by 60%, and laser peripheral iridectomy (PI) by 30%. Cataract extractions have increased by 52%. Medical treatments, especially prostaglandin use, have increased. The number of admissions for acute glaucoma did not increase.


CONCLUSIONS
The figures indicated a decrease in glaucoma drainage surgery and an increase in cataract extraction-consistent with other studies. More surprisingly, there was no increase in diagnosis of angle closure glaucoma or laser PIs within the figures and we suggest this may in part be related to the increase in cataract extraction. We speculate that this may also partly be responsible for the reduction in trabeculectomies. Although the HES data are a potentially rich source of information, there are potential inaccuracies in the data, which means interpretations must be made with caution.
Fraser
S G
SG
Sunderland Eye Infirmary, Sunderland, Tyne and Wear, UK. sfraser100@totalise.co.uk
Wormald
R P L
RP
D002387:Cataract Extraction / Q000706:statistics & numerical data* / Q000639:trends; D016208:Databases, Factual / Q000706:statistics & numerical data; D005901:Glaucoma / Q000188:drug therapy / Q000601:surgery*; D006761:Hospitals / Q000706:statistics & numerical data; D006801:Humans; D011453:Prostaglandins / Q000627:therapeutic use; D013222:State Medicine / Q000706:statistics & numerical data* / Q000639:trends; D014130:Trabeculectomy / Q000706:statistics & numerical data* / Q000639:trends; D006113:United Kingdom
D011453:Prostaglandins