title: AGE, SEX, AND TIME-SPECIFIC TRENDS IN SURGICAL APPROACHES FOR RHEGMATOGENOUS RETINAL DETACHMENT: A Nationwide, Population-Based Study Using the National Claim Registry.
abstract: OBJECTIVE
  To investigate the primary surgical approach for rhegmatogenous retinal detachment (RRD) according to age group, sex, and year in Korea.
  
  
  METHODS
  We retrospectively identified patients from the national claims database who underwent primary surgery for RRD from 2007 to 2011 using the diagnostic code and surgical codes for RRD. Patients were categorized into three groups according to surgical treatment; scleral buckling, vitrectomy, and combined operation. We analyzed the frequency and proportion of primary surgical approach for RRD according to age group, sex, and year.
  
  
  RESULTS
  Of 24,928 RRD patients, 11,372 (45.6%) patients underwent scleral buckling, 10,583 (42.5%) patients underwent vitrectomy, and 2,973 (11.9%) underwent a combined operation. Regression analysis showed that relative proportion of surgical approach had linear relationship with age; the percentage of patients undergoing vitrectomy increased by an average of 7.55% every 10 years (P < 0.001). This age-related trend was observed for both sexes. Scleral buckling tended to be preferred in younger patients (<45 years) and vitrectomy in older patients (≥45 years). Men tended to undergo vitrectomy significantly more than women in patients aged 15 years to 34 years. There was no consistent trend over time in the primary surgical approach during the study period.
  
  
  CONCLUSIONS
  Age and sex of RRD patients influence the selection of primary surgical approaches. Young patients tend to undergo scleral buckling, whereas older patients tend to receive vitrectomy. Among young patients, men are more likely to undergo vitrectomy than women. No discernible trend over time was observed in the surgical approach over the 5-year study period.
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Sang Jun
authors.initials: SJ
authors.lastname: Park
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.|Department of Bioinformatics and Statistics, Korea National Open University, Seoul, Republic of Korea.
authors.forename: Soo Chang
authors.initials: SC
authors.lastname: Cho
authors.affiliation: Institute of Environmental Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea.|Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.|Department of Health Convergence, Ewha Womans University, Seoul, South Korea.
authors.forename: Nam-Kyong
authors.initials: NK
authors.lastname: Choi
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Kyu Hyung
authors.initials: KH
authors.lastname: Park
authors.affiliation: Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Se Joon
authors.initials: SJ
authors.lastname: Woo
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007345:Insurance Claim Review / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D012163:Retinal Detachment / Q000453:epidemiology* / Q000601:surgery; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors; D057586:Vitreoretinal Surgery / Q000639:trends*; D055815:Young Adult