Eyeworld

EW CATARACT 32 August 2016 demonstrated 95,934 cataract surger- ies, which extrapolates to approxi- mately 3,757,697 cataract surgeries performed in the U.S. in 2010. The calculated prevalence of glaucoma among patients in the SAF undergo- ing cataract surgery was estimated to be approximately 20%. Conclusion: The prevalence of glaucoma among cataract surgery patients may be higher than report- ed in prior studies. Cataract surgery offers a unique opportunity for clini- cians to manage intraocular pressure as well as refractive outcomes. Dr. Tipperman: Clearly at the 2016 ASCRS•ASOA Symposium & Congress, one of the hot topics was MIGS for the cataract surgeon. This paper does not deal with MIGS, but rather analyzes the proportion of patients in a "regu- lar" cataract surgery practice who have glaucoma. I chose this paper because it highlights why MIGS is an important topic for every cataract surgeon to be aware of, and I was pleased to see how many different learning opportunities were available at the 2016 meeting for surgeons to learn more about this technology. In the past, studies estimated that the prevalence of POAG in a cataract surgery population ranged between 2 and 22%. This paper used actual claims data from the Medicare popula- tion. In this study, 19.5% of patients undergoing cataract surgery also had open angle glaucoma or borderline open angle glaucoma. This translates to 1 in 5 patients undergoing cataract surgery having a concurrent glaucoma diagnosis where at least a MIGS procedure should be considered at the time of surgery— clearly valuable information for all cataract surgeons. Prevalence of glaucoma in a cataract surgery population Anurag Shrivastava, MD, David Fried- man, MD, Kuldev Singh, MD, MPH, Jyoti Aggarwal, MHS Purpose: To use insurance claims to determine the estimated proportion of cataract surgery patients with concomitant glaucoma. Estimates of glaucoma prevalence among cataract surgery patients in the U.S. varies from 2–20%. Insurance claims can be used to more accurately deter- mine the prevalence of coexistent glaucoma in those undergoing cata- ract surgery. Methods: A structured literature re- view using the terms "cataract" and "glaucoma" compared published rates of glaucoma prevalence among those undergoing cataract surgery with data from 2010 Medicare Carri- er Standard Analytic File (SAF) with preoperative look back periods of 24 and 36 months. Almost 500 arti- cles were analyzed and reviewed to determine the estimated prevalence of glaucoma. Medicare fee-for-ser- vice claims were used to calculate the number of patients with primary and secondary glaucoma diagnoses in the same quarter as a cataract surgery claim. The data was analyzed to calculate multiple prevalence estimates of concomitant glaucoma in cataract surgery patients. Results: Estimated glaucoma prev- alence among cataract surgery pa- tients is between 8 and 11.2% based on systematic literature review. Of the original 496 papers reviewed, 17 met criteria and were abstracted accordingly. There were no papers specifically addressing glaucoma prevalence in a cataract surgery population in North America. Analy- sis of the Medicare 5% SAF data set Richard Tipperman, MD, highlighted the best cataract papers at the "Best of ASCRS" session at the 2016 ASCRS•ASOA Symposium & Congress. The papers were chosen from the Best Paper of Session winners. Here are the abstracts from the studies, with Dr. Tipperman's comments regarding selection. The session was moderated by Eric Donnenfeld, MD, with panelists Reay Brown, MD, Clara Chan, MD, David F. Chang, MD, and Boris Malyugin, MD. Best of ASCRS: Scan to watch video!

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