Drainage surgery going down; cataract surgery going up

The use of glaucoma drainage surgery is decreasing in Britain, which may be explained by an increase in cataract extraction, according to a report published in the January issue of Eye.

Scott Fraser from the Sunderland Eye Infirmary, Tyne and Wear and Richard Wormald from Moorfields Eye Hospital and the London School of Hygiene and Tropical Medicine, London, UK used National Health Service (NHS) Hospital Episode Statistics (HES) to investigate a reported decrease in the rate of glaucoma surgery and whether this may be linked to increased medical therapy options.

The HES was accessed for the main glaucoma procedures between 1998 and 2004 and for cataract operations performed over the same period. Diagnostic data was extracted for glaucoma and figures for the changes in glaucoma medications were obtained from pharmaceutical data.

Over the investigated time period, trabeculectomy had reduced by 51%, laser trabeculoplasty by 60% and laser peripheral iridectomy by 30%. Cataract extractions had increased by 52% and medical treatments, such as prostaglandin use, had also increased. The number of admissions for acute glaucoma did not increase.

The results of this review, as with previous studies, demonstrate that glaucoma drainage surgery is decreasing and that cataract extraction is increasing. However, it also revealed that there was no increase in the diagnosis of angle closure glaucoma, which the researchers think may be related to the increase in cataract extractions.