Abstract

Volume.123 Number.8

Original article : Clinical science

Recent Trends in Glaucoma Surgery in Japan: a Descriptive Study Using Large-scale Databases
Yohei Hashimoto1,3, Nobuaki Michihata2, Hiroki Matsui3, Hideo Yasunaga3, Makoto Aihara1
1 Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo
2 Department of Health Services Research, Graduate School of Medicine, The University of Tokyo
3 Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo

Purpose: To analyze recent trends in glaucoma surgery in Japan.
Subjects and methods: In this study, we employed the Diagnostic Procedure Combination (DPC) database of the DPC data research group for the Japanese Government Ministry of Health, Labour and Welfare and the open data of the National Database. The numbers of glaucoma surgery were obtained annually from 2010 to 2016 based on the surgery type, age, and cataract surgery simultaneously performed with glaucoma surgery.
Results: The number of filtration operation decreased from 6116 (66% of total surgery types) in 2011 to 4591 (47%) in 2013, followed by an increase to 6063 (50%) in 2016. Glaucoma drainage device (GDD) surgery without plates increased from 1034 (11%) in 2012 to 1778 (18%) in 2013 and decreased to 1366 (11%) in 2016. The number of outflow tract reconstruction increased from 2791 (34%) to 4185 (34%) over the course of 6 years. GDD with plates increased from 463 in 2014 to 588 in 2016. The numbers of surgery for the overall surgery types increased by 51% over the course of 6 years. The number of filtration operation was the highest in all ages; outflow reconstruction was the highest among patients aged from 0 to 14 years. The number of glaucoma surgery simultaneously performed with cataract surgery increased by 70% from 2460 to 4172 over the course of 6 years until 2016, of which the number of outflow tract reconstruction was the highest.
Conclusions: Increasing number of glaucoma surgery was observed in both overall surgery types and cataract surgery simultaneously performed with glaucoma surgery. The number of filtration operation remained the highest even after the use of GDDs in clinics.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 123: 815-823, 2019.

Key words
Glaucoma surgery, Diagnostic Procedure Combination (DPC) data, National Database (NDB) open data, Filtration operation, Glaucoma drainage device (GDD)
Reprint requests to
Yohei Hashimoto, M.D. Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo. 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan