Laser trabeculoplasty trends with the introduction of new medical treatments and selective laser trabeculoplasty. 2006

Rony Rachmiel, and Graham E Trope, and Mary L Chipman, and Peter Gouws, and Yvonne M Buys
Department of Ophthalmology and Visual Sciences, Toronto Western Hospital, Toronto, Ontario, Canada. rachmiel_r@hotmail.com

OBJECTIVE To correlate trends of laser trabeculoplasties (LTPs) with the introduction of medical therapies for glaucoma and to assess whether these trends changed after the introduction of selective laser trabeculoplasty (SLT) in 2001. METHODS A retrospective analysis of LTP numbers, filtration surgeries, glaucoma medications dispensed, and population distribution by age in Ontario, Canada, between April 1992 and March 2005. RESULTS The number of LTP per 1,000 persons estimated to have primary open angle glaucoma (POAG) increased from 138.05 in 1992 to a maximum of 149.23 in 1996 (8.1% increase, 1.96% annual increase) and then steadily decreased to 70.65 in 2001 (47.3% decrease, 14% annual decrease). From 2001 to 2004, the LTP rate increased to 162.54 (230% increase, 32% annual increase). The number of filtration surgeries per 1,000 persons estimated to have POAG steadily decreased from 1996 to 2004 by 21.42% (2.4% annual decrease). The number of glaucoma medications dispensed in Ontario increased from 1992 to 2004 by 91.5% (10.5% annual increase). There were no significant correlations between the LTP rates and the new glaucoma medications rates (r=-0.35 to 0.09; P=0.34 to 0.82) or filtration surgeries rates (r=0.007; P=0.98). CONCLUSIONS There was a substantial reduction in the number of LTP between 1997 and 2001 coinciding, but not correlated with the introduction of medications for the treatment of glaucoma. Between 2002 and 2004 the LTP rates increased, coinciding with the introduction of SLT.

UI MeSH Term Description Entries
D007429 Intraocular Pressure The pressure of the fluids in the eye. Ocular Tension,Intraocular Pressures,Ocular Tensions,Pressure, Intraocular,Pressures, Intraocular,Tension, Ocular,Tensions, Ocular
D009864 Ontario A province of Canada lying between the provinces of Manitoba and Quebec. Its capital is Toronto. It takes its name from Lake Ontario which is said to represent the Iroquois oniatariio, beautiful lake. (From Webster's New Geographical Dictionary, 1988, p892 & Room, Brewer's Dictionary of Names, 1992, p391)
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D005902 Glaucoma, Open-Angle Glaucoma in which the angle of the anterior chamber is open and the trabecular meshwork does not encroach on the base of the iris. Glaucoma Simplex,Glaucoma, Pigmentary,Glaucoma, Simple,Open-Angle Glaucoma,Chronic Primary Open Angle Glaucoma,Glaucoma, Compensated,Glaucoma, Compensative,Glaucoma, Open Angle,Glaucoma, Primary Open Angle,Glaucoma, Secondary Open Angle,Primary Open Angle Glaucoma,Secondary Open Angle Glaucoma,Compensated Glaucoma,Compensative Glaucoma,Open Angle Glaucoma,Open Angle Glaucomas,Open-Angle Glaucomas,Pigmentary Glaucoma,Simple Glaucoma,Simplex, Glaucoma,Simplices, Glaucoma
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000959 Antihypertensive Agents Drugs used in the treatment of acute or chronic vascular HYPERTENSION regardless of pharmacological mechanism. Among the antihypertensive agents are DIURETICS; (especially DIURETICS, THIAZIDE); ADRENERGIC BETA-ANTAGONISTS; ADRENERGIC ALPHA-ANTAGONISTS; ANGIOTENSIN-CONVERTING ENZYME INHIBITORS; CALCIUM CHANNEL BLOCKERS; GANGLIONIC BLOCKERS; and VASODILATOR AGENTS. Anti-Hypertensive,Anti-Hypertensive Agent,Anti-Hypertensive Drug,Antihypertensive,Antihypertensive Agent,Antihypertensive Drug,Anti-Hypertensive Agents,Anti-Hypertensive Drugs,Anti-Hypertensives,Antihypertensive Drugs,Antihypertensives,Agent, Anti-Hypertensive,Agent, Antihypertensive,Agents, Anti-Hypertensive,Agents, Antihypertensive,Anti Hypertensive,Anti Hypertensive Agent,Anti Hypertensive Agents,Anti Hypertensive Drug,Anti Hypertensive Drugs,Anti Hypertensives,Drug, Anti-Hypertensive,Drug, Antihypertensive,Drugs, Anti-Hypertensive,Drugs, Antihypertensive
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D014130 Trabeculectomy Any surgical procedure for treatment of glaucoma by means of puncture or reshaping of the trabecular meshwork. It includes goniotomy, trabeculectomy, and laser perforation. Goniotomy,Trabeculoplasty,Trabeculotomy,Goniotomies,Trabeculectomies,Trabeculoplasties,Trabeculotomies
D015995 Prevalence The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time. Period Prevalence,Point Prevalence,Period Prevalences,Point Prevalences,Prevalence, Period,Prevalence, Point,Prevalences

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