Reoperation Rates and Disease Costs for Primary Open-Angle Glaucoma Patients in the United States Treated with Incisional Glaucoma Surgery
| Autor: | Inder Paul Singh, Arsham Sheybani, Omar R. Sadruddin, E. Randy Craven, Stephanie Rhoten, Tiffany M. Yu |
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| Rok vydání: | 2022 |
| Předmět: |
Reoperation
medicine.medical_specialty Intraocular pressure genetic structures Open angle glaucoma medicine.medical_treatment Visual Acuity Glaucoma Medicare Cost of Illness medicine Glaucoma surgery Humans Trabeculectomy Glaucoma Drainage Implants Intraocular Pressure Aged Retrospective Studies business.industry ICD-10 General Medicine Cataract surgery medicine.disease United States eye diseases Surgery Current Procedural Terminology business Glaucoma Open-Angle |
| Zdroj: | Ophthalmology Glaucoma. 5:297-305 |
| ISSN: | 2589-4196 2010-2011 |
| DOI: | 10.1016/j.ogla.2021.10.011 |
| Popis: | Objective To evaluate the claims-based five-year economic and re-intervention burden for patients with primary open-angle glaucoma (POAG) following treatment with incisional glaucoma surgery in the United States Design Retrospective Medicare claims analysis Subjects 1945 Medicare fee-for-service patients with POAG treated with trabeculectomy, tube shunt, or EX-PRESS in 2010-2011 Methods POAG patients treated with incisional glaucoma surgeries (trabeculectomy, tube shunt, or EX-PRESS) in 2010-2011 were identified in the Medicare 5% Standard Analytical Files. Ten years of claims data for each patient (2005-2016) were evaluated for prior incisional surgeries and downstream procedures in the treated eye within 5 years of index. Patients’ baseline characteristics, downstream procedures, and total all-payer POAG-related index and downstream costs were evaluated. The proportions of patients with downstream procedures in the index eye indicating failure of the index surgery, glaucoma reoperations, non-failure complications, interventions, or cataract surgery was assessed over five years of follow-up. Main Outcome Measures Cumulative rates of index surgery failure and reoperations for glaucoma over five years following incisional glaucoma surgery Results A total of 1,945 patients were included: 223 EX-PRESS, 551 tube shunt, and 1,171 trabeculectomy patients. Overall rates of procedures likely indicating failure, reoperations for glaucoma, or non-failure complications rose over five years post-index for all patient subgroups. At one year, 15.1% of EX-PRESS patients, 11.6% of tube shunt patients, and 8.8% of trabeculectomy patients had experienced failure based on post-index procedures. By five years follow-up, these rates were 37.1% of EX-PRESS patients, 27.1% of tube shunt patients, and 23.5% of trabeculectomy patients. Rates of reoperations for glaucoma at five years were 18.3%, 15.1%, and 14.0%, respectively. Among tube shunt and trabeculectomy patients with prior incisional surgery preceding index, the five-year failure rates were 32.5% and 32.6%, and reoperations rates were 12.0% and 26.1%, respectively. Conclusions Over one-fourth of incisional surgery treated POAG patients had additional procedures to address index surgery failure within five years. Of these, over half had additional incisional glaucoma surgery. These real-world outcomes demonstrate that POAG patients who require incisional surgery continue to need additional safe and effective surgical treatment options to manage their glaucoma. |
| Databáze: | OpenAIRE |
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