Ye Lin Kwan, Qilian Sheng, Yanan Sun, Yue Ying, Ruyi Zhai, Xiangmei Kong
{"title":"Shifting Paradigms in Glaucoma Management: A Retrospective Analysis from 2013 to 2023.","authors":"Ye Lin Kwan, Qilian Sheng, Yanan Sun, Yue Ying, Ruyi Zhai, Xiangmei Kong","doi":"10.1080/09286586.2025.2474652","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>This study analyzes trends in glaucoma surgical management at the Eye & ENT Hospital of Fudan University over a 10-year period (2013-2023), focusing on the evolution of surgical practices and the adoption of new techniques.</p><p><strong>Methods: </strong>A retrospective observational study was conducted using medical records of patients diagnosed with glaucoma who underwent surgery between January 1, 2013, and December 31, 2023. Data were analyzed using the Cochrane-Armitage trend test.</p><p><strong>Results: </strong>A total of 13,092 glaucoma surgeries were performed, increasing from 736 in 2013 to 2,451 in 2023. Primary angle-closure glaucoma (PACG) accounted for 71.00% (9247/13092) of cases. Patients were predominantly aged 40-64 (43.56%) and 65+ (41.12%), with 56.60% female and 43.40% male. Internal filtration surgeries dropped between 2013-2015 but rose from 2.95% (26/880) in 2015 to 7.87% (193/2451) in 2023. External filtration surgeries declined from 82.47% (607/736) to 26.56% (651/2451). Phacoemulsification combined with goniosynechialysis (Phaco+GSL) increased from 7.61% (56/736) to 65.36% (1602/2451), while cyclodestruction procedures remained stable (0.54% to 0.20%). In congenital glaucoma (CG), ab interno trabeculotomy rose to 52.74% (77/146) by 2023. External filtration for primary open-angle glaucoma (POAG) decreased from 98.54% (135/137) to 74.82% (312/417), while Phaco+GSL for PACG increased from 11.43% (56/490) to 84.36% (1591/1886). Among glaucoma drainage devices (GDDs), Ahmed Glaucoma Valve usage declined from 94.25% (246/261) to 61.66% (193/313), while the Ex-Press device was phased out, and XEN Gel Stent (MIGS) usage rose to 38.34% (120/313).</p><p><strong>Conclusion: </strong>Glaucoma surgical management at the Eye & ENT Hospital of Fudan University has evolved significantly over the past decade, with a notable shift towards minimally invasive procedures and personalized treatment strategies.</p>","PeriodicalId":19607,"journal":{"name":"Ophthalmic epidemiology","volume":" ","pages":"1-9"},"PeriodicalIF":1.7000,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Ophthalmic epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/09286586.2025.2474652","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: This study analyzes trends in glaucoma surgical management at the Eye & ENT Hospital of Fudan University over a 10-year period (2013-2023), focusing on the evolution of surgical practices and the adoption of new techniques.
Methods: A retrospective observational study was conducted using medical records of patients diagnosed with glaucoma who underwent surgery between January 1, 2013, and December 31, 2023. Data were analyzed using the Cochrane-Armitage trend test.
Results: A total of 13,092 glaucoma surgeries were performed, increasing from 736 in 2013 to 2,451 in 2023. Primary angle-closure glaucoma (PACG) accounted for 71.00% (9247/13092) of cases. Patients were predominantly aged 40-64 (43.56%) and 65+ (41.12%), with 56.60% female and 43.40% male. Internal filtration surgeries dropped between 2013-2015 but rose from 2.95% (26/880) in 2015 to 7.87% (193/2451) in 2023. External filtration surgeries declined from 82.47% (607/736) to 26.56% (651/2451). Phacoemulsification combined with goniosynechialysis (Phaco+GSL) increased from 7.61% (56/736) to 65.36% (1602/2451), while cyclodestruction procedures remained stable (0.54% to 0.20%). In congenital glaucoma (CG), ab interno trabeculotomy rose to 52.74% (77/146) by 2023. External filtration for primary open-angle glaucoma (POAG) decreased from 98.54% (135/137) to 74.82% (312/417), while Phaco+GSL for PACG increased from 11.43% (56/490) to 84.36% (1591/1886). Among glaucoma drainage devices (GDDs), Ahmed Glaucoma Valve usage declined from 94.25% (246/261) to 61.66% (193/313), while the Ex-Press device was phased out, and XEN Gel Stent (MIGS) usage rose to 38.34% (120/313).
Conclusion: Glaucoma surgical management at the Eye & ENT Hospital of Fudan University has evolved significantly over the past decade, with a notable shift towards minimally invasive procedures and personalized treatment strategies.
期刊介绍：
Ophthalmic Epidemiology is dedicated to the publication of original research into eye and vision health in the fields of epidemiology, public health and the prevention of blindness. Ophthalmic Epidemiology publishes editorials, original research reports, systematic reviews and meta-analysis articles, brief communications and letters to the editor on all subjects related to ophthalmic epidemiology. A broad range of topics is suitable, such as: evaluating the risk of ocular diseases, general and specific study designs, screening program implementation and evaluation, eye health care access, delivery and outcomes, therapeutic efficacy or effectiveness, disease prognosis and quality of life, cost-benefit analysis, biostatistical theory and risk factor analysis. We are looking to expand our engagement with reports of international interest, including those regarding problems affecting developing countries, although reports from all over the world potentially are suitable. Clinical case reports, small case series (not enough for a cohort analysis) articles and animal research reports are not appropriate for this journal.
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