title: Trends in glaucoma surgical procedures in Ontario: 1992-2012.
abstract: OBJECTIVE
  To analyze trends in the surgical management of glaucoma in Ontario over the past 2 decades.
  
  
  METHODS
  Retrospective analysis of health records.
  
  
  METHODS
  Ontario Health Insurance Plan billing service claims between 1992 and 2012 were analyzed for the yearly number of glaucoma laser and incisional surgical procedures. The yearly number of Ontarians with primary open-angle glaucoma (POAG) was estimated by applying composite prevalence curves to published population data and the yearly number of procedures per 1000 Ontarians with POAG was calculated.
  
  
  RESULTS
  Per 1000 people with POAG, laser trabeculoplasty (LT) rates increased nearly 2-fold (185%) from 1992 to 2012, with the rates stabilizing between 2008 and 2012, and total glaucoma filtration procedure (GFP) rates (trabeculectomy, aqueous shunts, and combined GFP and cataract extraction) in 2012 were similar to those in 1992, with a peak rate noted in 1996. Shunts represented 0.9% of GFP in 1992 and 33% in 2012. Data for combination codes billed on the same day for the same patient were available from 2000. From 2000 to 2012 the rates of trabeculectomy alone remained unchanged, the number of aqueous shunts alone increased more than 5-fold, combined trabeculectomy and cataract extraction decreased 81%, whereas combined shunts and cataract extraction increased from 6 in 2000 to 420 in 2012. Combined aqueous shunts and cataract extraction represented 0.4% of combined cataract extractions in 2000 and 26.3% in 2012.
  
  
  CONCLUSIONS
  Over the past 2 decades there was an overall increase in the rate of LT, no change in the rate of trabeculectomies, and a significant increase in aqueous shunt surgery.
authors.affiliation: Faculty of Medicine.
authors.forename: Andrei-Alexandru
authors.initials: AA
authors.lastname: Szigiato
authors.affiliation: Department of Ophthalmology and Vision Sciences.
authors.forename: Graham E
authors.initials: GE
authors.lastname: Trope
authors.affiliation: Department of Ophthalmology and Vision Sciences; Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.
authors.forename: Yaping
authors.initials: Y
authors.lastname: Jin
authors.affiliation: Department of Ophthalmology and Vision Sciences. Electronic address: y.buys@utoronto.ca.
authors.forename: Yvonne M
authors.initials: YM
authors.lastname: Buys
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D005260:Female; D020327:Glaucoma Drainage Implants / Q000639:trends*; D005902:Glaucoma, Open-Angle / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D007429:Intraocular Pressure; D032801:Iridectomy / Q000639:trends*; D007498:Iris / Q000601:surgery; D053685:Laser Therapy / Q000639:trends; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data; D009864:Ontario / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D014130:Trabeculectomy / Q000639:trends*