Ruhella R Hossain1,2, Stephen Guest3, Henry B Wallace4, James McKelvie5,6. 1. Department of Ophthalmology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. 2. Department of Ophthalmology, Hawkes Bay District Health Board, Hastings, New Zealand. 3. Department of Ophthalmology, Waikato District Health Board, Hamilton, New Zealand. 4. Department of Ophthalmology, Capital & Coast District Health Board, Wellington, New Zealand. 5. Department of Ophthalmology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. james@mckelvie.co.nz. 6. Department of Ophthalmology, Waikato District Health Board, Hamilton, New Zealand. james@mckelvie.co.nz.
Abstract
BACKGROUND: Surgical intervention rates (SIR) provide a proxy measure of disease burden, surgical capacity, and the relative risk-benefit ratio of surgery. The current study assessed decade trends in ophthalmic surgery and calculated SIRs for all major classes of commonly performed ophthalmic procedures in New Zealand. METHODS: Retrospective population-based analysis of all ophthalmic surgical procedures performed in New Zealand from 2009 to 2018. National and regional datasets from public and private health sectors and industry were analysed. SIRs were calculated for all major ophthalmic procedures, and subgrouped by patient demographics. RESULTS: There were 410,099 ophthalmic surgical procedures completed with a 25.3% overall increase over 10 years. Procedures were mostly government-funded (51%, n = 210,830) with 71% of patients aged over 64 years. Cataract surgery (78%, n = 318,564) had the highest mean SIR (703/100,000/year) and increased by 25% during the study period, consistent with population growth in the over 64 years old age group. Vitrectomy surgery had the second highest mean SIR (67/100,000/year) and increased by 50%, well above national population growth during the study period. Other SIRs included conjunctival lesion-biopsy (38/100,000/year), glaucoma (33/100,000/year), strabismus (20/100,000/year), dacryocystorhinostomy (10/100,000/year), and keratoplasty surgery (4/100,000/year). CONCLUSIONS: This comprehensive review of New Zealand ophthalmic surgery reports increasing SIRs that cannot be explained by population growth alone. Cataract surgery numbers increased year on year consistent with the increase in the over 64 years old population. Vitrectomy surgery growth exceeded that of the national population, including those over 64 years.
BACKGROUND: Surgical intervention rates (SIR) provide a proxy measure of disease burden, surgical capacity, and the relative risk-benefit ratio of surgery. The current study assessed decade trends in ophthalmic surgery and calculated SIRs for all major classes of commonly performed ophthalmic procedures in New Zealand. METHODS: Retrospective population-based analysis of all ophthalmic surgical procedures performed in New Zealand from 2009 to 2018. National and regional datasets from public and private health sectors and industry were analysed. SIRs were calculated for all major ophthalmic procedures, and subgrouped by patient demographics. RESULTS: There were 410,099 ophthalmic surgical procedures completed with a 25.3% overall increase over 10 years. Procedures were mostly government-funded (51%, n = 210,830) with 71% of patients aged over 64 years. Cataract surgery (78%, n = 318,564) had the highest mean SIR (703/100,000/year) and increased by 25% during the study period, consistent with population growth in the over 64 years old age group. Vitrectomy surgery had the second highest mean SIR (67/100,000/year) and increased by 50%, well above national population growth during the study period. Other SIRs included conjunctival lesion-biopsy (38/100,000/year), glaucoma (33/100,000/year), strabismus (20/100,000/year), dacryocystorhinostomy (10/100,000/year), and keratoplasty surgery (4/100,000/year). CONCLUSIONS: This comprehensive review of New Zealand ophthalmic surgery reports increasing SIRs that cannot be explained by population growth alone. Cataract surgery numbers increased year on year consistent with the increase in the over 64 years old population. Vitrectomy surgery growth exceeded that of the national population, including those over 64 years.
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