Glaucoma laser and surgical procedure rates in Canada: a long-term profile.
BACKGROUND
New laser and surgical techniques have had a significant effect on glaucoma therapy. A precise understanding of how these developments are affecting overall glaucoma management is fundamental to health services planning. The objective of this study was to synthesize Canadian national and provincial data regarding glaucoma laser and surgical procedure rates from 1992 to 2004.


METHODS
Canadian provincial health insurance databases, which cover virtually all surgical procedures provided domestically to Canadians, were accessed to ascertain yearly total glaucoma procedure numbers. To estimate the number of individuals with glaucoma, an age-stratified glaucoma prevalence model was applied to population census data.


RESULTS
Laser trabeculoplasty rates dramatically increased between 2001 and 2004 with the national Canadian rate more than doubling. However, this increase varied widely across regions, ranging from 0% to 530%. Trabeculectomy surgery rates slowly increased from 1992 to 1995, then declined by 29% nationally between 1995 and 2004. Implantation rates of glaucoma drainage devices increased 12-fold nationally between 1992 and 2004; by 2004 this procedure accounted for 10% of incisional glaucoma surgical procedures in Canada.


CONCLUSIONS
In Canada, laser trabeculoplasty rates have risen significantly over recent years. Trabeculectomy rates have recently declined, and implantation of glaucoma drainage devices is playing an increasingly important role in glaucoma management in this country.
Campbell
Robert J
RJ
Department of Ophthalmology, Queen's University, Hotel Dieu Hospital, Kingston, Ontario, Canada. rob.campbell@queensu.ca
Trope
Graham E
GE
Rachmiel
Rony
R
Buys
Yvonne M
YM
D002170:Canada; D003695:Delivery of Health Care; D005901:Glaucoma / Q000601:surgery*; D020327:Glaucoma Drainage Implants / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D053685:Laser Therapy / Q000706:statistics & numerical data*; D013222:State Medicine; D014130:Trabeculectomy / Q000706:statistics & numerical data*; D019472:Universal Health Insurance / Q000706:statistics & numerical data