Rachmiel Rony, Trope Graham E, Chipman Mary L, Gouws Pieter, Buys Yvonne M
Department of Ophthalmology and Visual Sciences, Toronto Western Hospital, and Department of Public Health Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario.
Arch Ophthalmol. 2006 Oct;124(10):1472-7. doi: 10.1001/archopht.124.10.1472.
To analyze trends of glaucoma filtration surgery in Ontario.
From April 1, 1992, through March 31, 2004, correlations were examined between the annual rates of trabeculectomies in Ontario, the use of glaucoma medications, and the numbers of practicing ophthalmologists and optometrists.
The number of trabeculectomies per 1000 persons at risk for primary open-angle glaucoma increased from 33.5 in 1992 to 46.2 in 1996 (37.7% increase; 6.6% increase per year) and then steadily decreased to 38.2 in 2004 (17.0% decrease; 2.7% decrease per year). The number of glaucoma medications dispensed in Ontario increased from 766 000 in 1992 to 1 466 543 in 2004 (91.5% increase; 10.5% annual increase). The increase in dispensed prostaglandin analogues strongly correlated (P<.001; 95% confidence interval, -0.87 to -0.41) with the decreasing number of trabeculectomies. The decreasing number of ophthalmologists positively correlated (r = 0.87) with the filtration surgery rate after 1997.
The number of trabeculectomies has decreased substantially in Ontario coinciding with the introduction of medications for the treatment of glaucoma in December 1996. This decrease in trabeculectomies highly correlated with the introduction of prostaglandin analogues (P<.001) and the decreasing number of ophthalmologists from 1997 through 2004.
分析安大略省青光眼滤过手术的趋势。
从1992年4月1日至2004年3月31日，对安大略省小梁切除术的年手术率、青光眼药物的使用情况以及执业眼科医生和验光师的数量之间的相关性进行了研究。
每1000名原发性开角型青光眼风险人群中的小梁切除术数量从1992年的33.5例增加到1996年的46.2例（增加37.7%；每年增加6.6%），然后稳步下降至2004年的38.2例（下降17.0%；每年下降2.7%）。安大略省发放的青光眼药物数量从1992年的76.6万剂增加到2004年的146.6543万剂（增加91.5%；年增长率为10.5%）。前列腺素类似物发放量的增加与小梁切除术数量的减少密切相关（P<0.001；95%置信区间，-0.87至-0.41）。1997年后，眼科医生数量的减少与滤过手术率呈正相关（r = 0.87）。
安大略省小梁切除术的数量大幅下降，这与1996年12月引入青光眼治疗药物的时间相吻合。小梁切除术数量的减少与前列腺素类似物的引入（P<0.001）以及1997年至2004年眼科医生数量的减少高度相关。
