Temporal Trends Are Noted for US Retinal Detachment Repair Procedures

Dr. Parisa Emami discussed “Temporal Trends and Regional Variations in Retinal Detachment Repair Procedures in the United States” in her presentation at the American Society of Retina Specialists 2024 Annual Meeting in Stockholm. Dr. Emami opened by stating that retinal detachment (RD) has an overall incidence rate of 1 in 10,000, and is one of the leading causes of blindness worldwide. In the United States (US), variations exist regarding RD practice patterns, including which treatment to use as the first option.

Heterogeneity in Retinal Detachment Repair

Dr. Emami then discussed the findings of a study conducted to evaluate practice patterns for RD repair in the US over time and the possible factors affecting these variations. It reviewed 2013–2021 Medicare fee-for-service data and assessed the number of RD repair procedures and trends over time, Medicare reimbursements for RD repair, and surgeon-related factors.

A total of 467,220 procedures were identified, with the number of procedures increasing during the time period. Utilization of pars plana vitrectomy (PPV) increased by 21%, while scleral buckle (SB) decreased by 23%. In all US regions, the most widely performed procedure was PPV. Pneumatic retinopexy was performed more often in the Northeast than in other regions.

Reductions in Medicare Reimbursements

Average Medicare reimbursements for RD repair decreased over time, from $4700.50 in 2013 to $3337.10 in 2021. Reimbursements decreased by 26.7% for PPVs and by 19.0% for SBs.

Gender Disparities

About 13% of the 1985 ophthalmologists were female, but only 8.3% of the RD repairs were performed by female surgeons. Female ophthalmologists preferred performing PPVs, but they received lower reimbursements than men for PPVs (as well as lower reimbursements for complex procedures).

In closing, Dr. Emami stated that “Trends in reimbursement and regional variation can affect [the] landscape of RD procedures, patient outcomes, and training of [the] future generation of specialists.”