Sarah Chaudhry1

Purpose: Common glaucoma procedures include glaucoma filtration surgery, insertion of drainage devices such as the Molteno tube, goniotomy, MIGS, laser iridotomy and trabeculoplasty. This paper aimed to assess the utilization of these procedures in Australia and their respective demographics.

Methods: Item numbers 42 746, 42 752, 42 758, 42 705, 42 785, 42 782 Medicare Benefits Schedule (privately billed data) was assessed. Analysis from 2009 to 2019 assessed the overall trend across Australia, and the demographics of patients requiring the services.

Results: Over the last decade glaucoma filtration surgery, Molteno tube insertion, laser iridotomy and laser trabeculoplasty has steadily increased in Australia. NSW appears to perform the greatest number of surgeries, and the age demographic is largely within the 65‐74 age group. There is no significant difference in gender distribution. Interestingly there appears to be a spike in goniotomy procedures from 2015 to 2017 after which there is a dramatic decline (162%). This corresponds to the new rebate for MIGS in 2017 which concurrently shows a 90% increase in MIGS procedures. Goniotomy was no longer allowed to be used for the insertion of MIGS and so subsequently dropped considerably.

Conclusion: There is a substantial glaucoma burden in Australia and surgical options continue to grow in demand. The advent of MIGS brought a slight difficulty in using the product and attaining a rebate for patients. With the new rebate 42 705, the process has become far more streamlined and more patients are able to access this treatment option. It will also help monitor the trajectory of this therapeutic procedure.