Academic journal article Journal of Visual Impairment & Blindness

Glaucoma Surgeries of Medicare Patients Examined in Large-Scale Study

Academic journal article Journal of Visual Impairment & Blindness

Glaucoma Surgeries of Medicare Patients Examined in Large-Scale Study

Article excerpt

As ophthalmologists continue to develop treatments to help the more than three million Americans with glaucoma, the July issue of Ophthalmology includes a large-scale national study of the outcomes of surgeries used to reduce intraocular pressure inside the eyes of Medicare patients. Lead investigator Frank A. Sloan--the J. Alex McMahon professor of health policy and professor of economics, Center for Health Policy, Duke University--and colleagues analyzed the claims records of 14,491 Medicare beneficiaries diagnosed with glaucoma who received one of three types of incisional surgeries (meaning that incisions were used improve the drainage of fluid from the eye to reduce intraocular pressure) that occurred between 1994 and 2003--primary trabeculectomy, trabeculectomy in the presence of scarring from previous ocular surgery or trauma, or implantation of a glaucoma drainage device. Study patients were at least 68 years of age, but not older than age 96, during the period analyzed. Patients' Medicare claim records, including those for post-surgery follow-ups, were analyzed to determine post-surgery rates of severe or less severe outcomes following the surgeries, the need for additional glaucoma-related surgeries, or progression to low vision or blindness. The study found that, although adverse outcomes were uncommon for all three types of surgeries, the rates of severe outcomes, less severe outcomes, and progression to low vision or blindness were higher for persons who received glaucoma drainage devices than for those who received primary trabeculectomies or trabeculectomies in the presence of scarring. …

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