Trends In Patient, Surgeon, And Procedural Characteristics Of Intraocular Lens Exchange Among Medicare Beneficiaries 2011-2020
Published 2024 - 42nd Congress of the ESCRS
Reference: PO298 | Type: Free paper | DOI: 10.82333/rfr3-v809
Authors: Hyeck Soo Son* 1 , Jane Huang 2 , Chen Dun 2 , David F. Chang 3 , Martin Makary 4 , Yassine Daoud 2 , Divya Srikumaran 2 , Fasika A. Woreta 2
1Wilmer Eye Institute,Baltimore,United States;University of Heidelberg,Heidelberg,Germany, 2Wilmer Eye Institute,Baltimore,United States, 3Altos Eye Physicians,Los Altos,United States, 4Department of Surgery,Johns Hopkins School of Medicine,Baltimore,United States
Purpose
Intraocular lenses (IOL) may occasionally require exchange. This study aimed to assess trends in prevalence and patient/surgeon characteristics of IOL exchange surgery in the United States and to identify surgical complications.
Setting
Retrospective cross-sectional analysis.
Methods
48,967 Medicare beneficiaries aged 65 years or older who underwent IOL exchange surgery between 2011-2020 were identified from 100% Medicare fee-for-service carrier claims data (n=52,583 procedures). Exclusion criteria: missing demographic information, incomplete follow-up data, or not having 12-months of continuous enrollment in Medicare Parts A and B prior to surgery. Main outcomes: incidence of IOL exchange, patient- and surgeon-level factors, and postoperative complication rates.
Results
The annual number of IOL exchanges increased from 4,621 in 2011 to 6,114 in 2019. Most patients were White (89.6%), resided in urban locations (83.9%), and had a Charlson comorbidity index of ≤2 (79.0%). Of 7,493 surgeons, most were male (84.2%), practiced in urban locations (92.2%), and had an average of 24.7±11.2 years between medical school graduation and the last surgery they performed during the study period. The most common surgical indications were mechanical lens failure (51.4%) and lens displacement (21.1%). The most common complications were epiretinal membrane (6.8%), mechanical lens complication (5.9%), and dislocation of the replacement IOL (4.9%).
Conclusions
The number of IOL exchange procedures performed among Medicare beneficiaries increased over the last decade. Most IOL exchange surgeons were male physicians in urban locations. The most common post-operative complication was epiretinal membrane. The rates of corneal decompensation, retinal detachment, and endophthalmitis were low.