Clinical Ophthalmology (Jun 2022)
Proportion of Glaucoma Types and Surgeries Among Young, Pre-Old, Old, and Oldest-Old Age Groups or Different Sex Groups
Abstract
Masaki Tanito,1 Yotaro Matsuoka2 1Department of Ophthalmology, Shimane University Faculty of Medicine, Izumo, Shimane, Japan; 2Division of Ophthalmology, Matsue Red Cross Hospital, Matsue, Shimane, JapanCorrespondence: Masaki Tanito, Department of Ophthalmology, Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan, Tel +81-853-20-2284, Fax +81-853-20-2278, Email [email protected]: We report the real-world distribution of glaucoma types and glaucoma surgeries in each age or sex group in our department.Methods: The department database of Matsue Red Cross Hospital, a tertiary care hospital, for eyes surgically treated to manage glaucoma between April 2014 and March 2018 was searched. Patient age, sex, disease type, and surgical procedure were collected from the database. The age was stratified by ≤ 64 years (young), 65– 74 years (pre-old), 75– 89 years (old), and ≥ 90 years (oldest-old or super-old).Results: In the database, 2036 consecutive surgeries (70.3 ± 14.4 years; 1015 males) were identified. Among all subjects, primary open-angle glaucoma (POAG) (42.7%) was the most frequent identifiable glaucoma type followed by primary angle-closure disease (PACD) (18.8%) and exfoliation glaucoma (17.9%). The glaucoma types differed significantly among the age groups (P < 0.0001); POAG was the most frequent type of glaucoma in young and pre-old groups, while PACD and exfoliation glaucoma were the most frequent glaucoma types in the oldest-old group. Among all subjects, trabeculotomy or other goniotomy/gonio-bypass surgery (41.7%) was the most frequent glaucoma surgery followed by long-tube shunt (22.1%) and trabeculectomy (16.2%). The glaucoma surgeries performed differed significantly among the age groups (P < 0.0001). The frequency of trabeculectomy was the highest in the young group (27.8%), trabeculotomy was the highest in the pre-old (42.6%) and old (46.6%) groups, and long tube shunt (41.3%) and cataract extraction + goniosynechialysis (32.6%) were the highest in the oldest-old group. The glaucoma type (P < 0.0001) and surgeries performed (P < 0.0001) differed significantly between sex groups; the rates of PACD and cataract extraction + goniosynechialysis were remarkably higher in female than male group.Conclusion: The types of glaucoma and required glaucoma surgeries differ among the different age groups and sexes. Primary angle-closure disease and exfoliation glaucoma are the major glaucoma types in the old and oldest-old age groups.Keywords: primary open-angle glaucoma, POAG, primary angle-closure disease, PACD, exfoliation glaucoma, trabeculotomy, trabeculectomy, minimally invasive glaucoma surgery, MIGS, cataract extraction
