Nationwide trends in macular hole, epiretinal membrane and floaters surgery, 2010-2023

PURPOSE: To examine the incidence of pars plana vitrectomy (PPV) for full-thickness macular hole (FTMH), epiretinal membrane (ERM) and floaters over time and across regions in Denmark.

METHODS: This nationwide registry-based study included all patients undergoing PPV for FTMH, ERM, or floaters in Denmark from 2010 to 2023. Crude and age-standardized incidence rates were calculated using Poisson regression, stratified by sex, age, region and year.

RESULTS: Among 11 693 patients undergoing PPV, the median age was 71 years (IQR, 66-76) and 83% (9744/11 693) were pseudophakic at surgery. Overall incidence rates per 100 000 person-years were 5.7 (95% CI, 5.5-5.8) for FTMH, 7.1 (6.9-7.2) for ERM, and 1.8 (1.7-1.9) for floaters. FTMH surgery was more common in females across all ages, while ERM and floater surgeries were more frequent in males aged ≥60 years. From 2010-2012 to 2021-2023, the incidence increased for FTMH and ERM, while floater surgery declined in females and remained stable in males. Regional variation was observed for all indications, most notably for ERM.

CONCLUSION: The incidence of PPV for both FTMH and ERM rose significantly from 2010 to 2023. The regional variation in FTMH may indicate undertreatment, while differences in ERM and floater surgeries reflect the absence of standardized guidelines for ERM and floater surgery, underscoring the need for national guidelines to ensure equitable ophthalmic care.