Trends in the National Ophthalmological Healthcare Focusing on Cataract, Retina, and Glaucoma Over 15 Years in Japan

Abstract

To assess the trends in ophthalmic healthcare, especially those of cataract, vitreo-retinal diseases, and glaucoma, the national data from the Japanese Ministry of Health, Labour and Welfare, which recorded medical practices for 126.1 million citizens, were studied for 15 years. The volume and expenses of cataract surgeries increased during this period; however, non-surgical expenses decreased. As a result, the total national cataract healthcare expenses decreased over the 15-year period. The volume of vitrectomies increased from 2007 to 2013. After introduction of anti-vascular endothelial growth factor (VEGF) injections, the number of injections increased 8.4 times from 2010 to 2021, while the volume of vitrectomy and retinal photocoagulation declined after 2019 and 2017, respectively. Minimally invasive glaucoma and long-tube shunt surgeries began to increase in 2015 and 2014, respectively. This trend contrasts with the decrease in trabeculectomies after 2019. The coronavirus disease-19 pandemic caused a 30.9% decrease in ophthalmological surgery expenses in 2020. The decreases in volume and expense were greater for cataract surgeries than for other surgeries. The pandemic had a stronger impact on ophthalmological healthcare than that on general medical healthcare. Advancements in technology and methodology have led to cost savings in national cataract healthcare, vitrectomy, and retinal photocoagulation while caused increase in the volume and expenditure of glaucoma surgeries and anti-VEGF injections over a span of 15 years in Japan.

Keywords:

• medical cost
• Japan
• cataract
• retina
• glaucoma
• vascular endothelial growth factor
• minimally invasive glaucoma surgery

Acknowledgments

This research did not receive any external funding. I am grateful for the support and encouragement provided by the Japan Ophthalmologist Association, headed by Dr. Shirane.

The internal review board did not require ethical approval for this study because the data were public and permission to use information from a database was not required.

Disclosure

The author reports no conflicts of interest in this work.