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Medicare expenditures decrease for glaucoma surgery as number of procedures increases
Date:7/13/2009

CHICAGO The overall number of glaucoma surgical procedures appears to be increasing, but payments by Medicare for the procedures have been decreasing, according to a report in the July issue of Archives of Ophthalmology, one of the JAMA/Archives journals.

Glaucoma is one of the leading causes of blindness worldwide and currently affects more than 2 million people in the United States, according to background information in the article. "Management and treatment of glaucoma can be costly, and it has been estimated that glaucoma is the primary reason for ophthalmologist visits in the United States," the authors write. One previous study estimated that annual Medicare payments for glaucoma exceeded $1.2 billion each year between 1991 and 2000. "An important driver of glaucoma treatment costs is surgery." Surgery is typically used to reduce intraocular pressure (pressure within the eye) when medications fail to do so.

Jordana K. Schmier, M.A., of Exponent Inc., Alexandria, Va., and colleagues conducted an analysis of Medicare claims and payments for glaucoma surgery between 1997 and 2006. The most common surgical treatments for glaucoma include laser trabeculoplasty, in which a beam of light changes the drainage angle of the eye to relieve pressure; filtering surgery, in which surgeons use a surgical tool to create a drainage hole; shunt surgery, which involves placement of a small plastic tube with an attached pouch; and cyclodestructive procedures, used to reduce the production of eye fluid in severe cases of glaucoma.

"Overall, there were decreases in both the number of glaucoma surgical procedures and the amount of annual payments from 1997 to 2001 but an increase in the number of procedures in the following years," the authors write.

"Trends in claims and payments vary according to procedure. Average payments for trabeculectomies decreased over time, while annual payments for cyclophotocoagulation [a type of cyclodes
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Contact: Jordana K. Schmier, M.A.
jschmier@exponent.com
571-227-7241
JAMA and Archives Journals
Source:Eurekalert

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