Trends in rates of retinal surgery in England from 1968 to 2004: studies of hospital statistics.

AIM: To describe trends over time and geographical variation in rates of vitreo-retinal surgery in England from 1968 to 2004. METHODS: Routinely collected hospital statistics were analysed for England, using the Hospital In-patient Enquiry and Hospital Episode Statistics from 1968 to 2004, and for the Oxford National Health Service Region using the Oxford Record Linkage Study from 1963 to 2004. RESULTS: Annual admission rates in England for surgery were about 5 episodes per 100 000 population in the 1960s, rising gradually to about 10 per 100 000 in the early 1990s, and then more sharply to 30 by 2004. The Oxford Record Linkage Study shows that multiple admissions per person were rare, which confirms that the observed increase represents a real increase in the number of people treated. Annual rates in England for buckle procedures declined to about 6 episodes per 100 000 population in 2004, whereas vitrectomy surgery rose to about 26 episodes per 100 000 population in 2004. CONCLUSION: Vitreo-retinal surgery has developed over the last 40 years in England, rapidly so over the past 15 years. Vitrectomy surgery has become much more common in England and buckle surgery has shown a steady decline. We demonstrate statistically significant geographical variation in the current annual rate of surgery between local authorities in England.