PATIENT AND SURGEON DISPARITIES IN RETINAL DETACHMENT REPAIR SURGERY IN THE MEDICARE POPULATION FROM 2011 TO 2021

To examine trends in retinal detachment (RD) repair surgeries from 2011 to 2021 in the Medicare population that characterizes the types of patients most at risk and in need of surgery. The authors also examined the impact of retinal surgeon demographics and location of practice on RD repair.

Retrospective study of RD repair surgeries performed between 2011 and 2021 on Medicare beneficiaries. Patient and surgeon characteristics associated with each claim were extracted and analyzed.

In total, 230,802 RD repair surgeries were performed on Medicare beneficiaries from 2011 to 2021. The amount of scleral buckle surgeries steadily declined from 6.38% of all surgeries in 2011 to 1.95% in 2021. The odds of having complex RD repair were associated with non-White race, higher area deprivation index, diabetes, and Charlson Comorbidity Index >0. Most retinal surgeons were male (84%) and practiced in urban areas (95.3%), although the proportion of female retinal surgeons increased over time. Around 20% of patients lived in rural areas, while only 4.7% of retina surgeons practiced in a rural setting. The annual surgical volume was higher for male compared with female surgeons (8.1 vs. 4.9, P < 0.001) and higher in surgeons practicing in rural than urban areas (9.3 vs. 7.5, P < 0.001).

Significant racial, geographic, and gender differences are observed within the Medicare patient population receiving RD repair surgeries, as well as significant geographic and gender disparities in the retinal surgery workforce. Further research and initiatives to explore and address these disparities are needed.