title: Recent trends in glaucoma surgery in Scotland, England and Wales.
abstract: OBJECTIVE
  To evaluate national trends of trabeculectomy, aqueous shunts and cycloablation performed in Scotland, England and Wales from 1993 to 2012.
  
  
  METHODS
  The annual numbers of trabeculectomies and aqueous shunts carried out between 1993 and 2012 were obtained from national Scottish, English and Welsh National Health Service databases. The annual rates of trabeculectomy, aqueous shunts and cycloablation were calculated per 100,000 of the population and analysed in the following age groups: 0-14 years, 15-59 years, over 60 years.
  
  
  RESULTS
  The highest annual rate of trabecuelctomy was in 1995, this was followed by a sharp decline and subsequent stable rates since 2000. The total annual rates of aqueous shunts have increased more than sixfold from 2003 to 2012. In the 0-14 years age group from 2003 to 2012 the ratio of trabeculectomy to aqueous shunts has reversed; trabeculectomy rates have decreased while rates of aqueous shunts have increased. From 2003 to 2012, rates of cyclocryotherapy have reduced while rates of photocoagulation to the ciliary body have doubled.
  
  
  CONCLUSIONS
  Trabeculectomy is the most commonly performed glaucoma operation. Aqueous shunts are rapidly increasing in the surgical management of glaucoma. During the study period, the ratio of trabeculectomy to aqueous shunts has reversed in the younger age group (0-14 years). Rates of cyclocyrotherapy to the ciliary body have dramatically declined while laser photocoagulation to the ciliary body is gaining wider acceptability.
authors.affiliation: Ophthalmology Department, Ninewells Hospital and Medical School, Dundee, UK.
authors.forename: Claire
authors.initials: C
authors.lastname: Murphy
authors.affiliation: Dundee Medical School, Dundee, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Ogston
authors.affiliation: Ophthalmology Department, Ninewells Hospital and Medical School, Dundee, UK.
authors.forename: Caroline
authors.initials: C
authors.lastname: Cobb
authors.affiliation: Ophthalmology Department, Ninewells Hospital and Medical School, Dundee, UK.
authors.forename: Caroline
authors.initials: C
authors.lastname: MacEwen
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D002924:Ciliary Body / Q000601:surgery*; D017679:Cryotherapy / Q000639:trends*; D004739:England / Q000453:epidemiology; D005901:Glaucoma / Q000453:epidemiology / Q000601:surgery*; D020327:Glaucoma Drainage Implants / Q000639:trends*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017075:Laser Coagulation / Q000639:trends*; D008875:Middle Aged; D012606:Scotland / Q000453:epidemiology; D013222:State Medicine / Q000706:statistics & numerical data; D014130:Trabeculectomy / Q000639:trends*; D014852:Wales / Q000453:epidemiology
keywords: Drugs; Field of vision; Glaucoma; Intraocular pressure; Optic Nerve