Global rates of glaucoma surgery.
OBJECTIVE
To estimate global rates of glaucoma surgery.


METHODS
National glaucoma and national ophthalmology societies were contacted to obtain rates of glaucoma surgery for the preceding 5 years. In countries without a professional society, leading ophthalmologists or non-governmental organizations (NGO) were approached. When available, published literature was used for the estimates. Three levels of evidence were assigned: published data from central government or insurance registries (level I), estimates provided by a national professional society based on survey of members (level II), and estimates based on data from individual glaucoma surgeons (level III). Glaucoma surgical rate (GSR) was defined as the annual number of total glaucoma surgeries performed per million population. Linear regression analysis was performed between GSR and the following parameters: population per ophthalmologist, per capita gross domestic product (GDP), and per capita health expenditures.


RESULTS
Seventy-three glaucoma societies, 35 ophthalmology societies, as well as six NGOs and 37 leading ophthalmologists (11 other countries) were contacted. Data were obtained from 38 countries (10 level I, 23 level II, and 5 lev el III) with a total population of 1.723 billion. The average GSR was 139.2 ± 113.1 (range, 2.9-500.0). There was a positive correlation between GSR and GDP (r(2) = 0.309, P = 0.0004) and GSR and the number of ophthalmologists (r(2) = 0.476, P < 0.0001).


CONCLUSIONS
There is a paucity of data on rates of glaucoma surgery, particularly from developing countries. The new metric GSR may be useful for the allocation of healthcare resources, as well as for planning and monitoring public health interventions in glaucoma.
Hamilton Glaucoma Center and the Shiley Eye Center, Department of Ophthalmology, University of California, San Diego, La Jolla, USA, kawehm@yahoo.com.
Kaweh
K
Mansouri
Felipe A
FA
Medeiros
Robert N
RN
Weinreb
D019049:Developed Countries; D003906:Developing Countries; D018463:Filtering Surgery / Q000706:statistics & numerical data*; D005901:Glaucoma / Q000453:epidemiology* / Q000601:surgery*; D014943:Global Health / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D009885:Ophthalmology / Q000458:organization & administration; D012955:Societies, Medical