Glaucoma laser and surgical procedure rates in Australia.

Aim: To determine trends in the number of glaucoma laser and surgical procedures performed in Australia between 1994 and 2014.

Methods: Medicare claims were analysed to determine the number of glaucoma-related procedures reimbursed in Australia between 1994 and 2014. Glaucoma procedures were identified by Medicare Benefits Schedule item number and analysed by age range, gender, state, month and year.

Results: Laser trabeculoplasty rates declined 60% between 1994 and 2003 before increasing a dramatic 353% between 2003 and 2014. Laser iridotomies increased 281% over the study period while cyclodestructive procedures increased 207%. The number of primary filtering operations for glaucoma fell 68% from a peak in 1996 to a low in 2006 and then remained stable. However, the number of filtering operations in eyes where a previous filtering operation had been performed increased 27%. There was a marked increase in glaucoma drainage device insertion, increasing 234% over the study period.

Conclusions: There has been a substantial increase in laser trabeculoplasty procedures in Australia, following a decline between 1994 and 2003. Primary filtering operations for glaucoma have declined in number while glaucoma drainage devices are playing an increasingly prominent role in the surgical management of glaucoma.