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Background: Surgical intervention rates (SIR) provide a proxy measure of disease burden, surgical capacity, and the relative risk-benefit ratio of surgery. The current study assessed decade trends in ophthalmic surgery and calculated SIRs for all major classes of commonly performed ophthalmic procedures in New Zealand., Methods: Retrospective population-based analysis of all ophthalmic surgical procedures performed in New Zealand from 2009 to 2018. National and regional datasets from public and private health sectors and industry were analysed. SIRs were calculated for all major ophthalmic procedures, and subgrouped by patient demographics., Results: There were 410,099 ophthalmic surgical procedures completed with a 25.3% overall increase over 10 years. Procedures were mostly government-funded (51%, n = 210,830) with 71% of patients aged over 64 years. Cataract surgery (78%, n = 318,564) had the highest mean SIR (703/100,000/year) and increased by 25% during the study period, consistent with population growth in the over 64 years old age group. Vitrectomy surgery had the second highest mean SIR (67/100,000/year) and increased by 50%, well above national population growth during the study period. Other SIRs included conjunctival lesion-biopsy (38/100,000/year), glaucoma (33/100,000/year), strabismus (20/100,000/year), dacryocystorhinostomy (10/100,000/year), and keratoplasty surgery (4/100,000/year)., Conclusions: This comprehensive review of New Zealand ophthalmic surgery reports increasing SIRs that cannot be explained by population growth alone. Cataract surgery numbers increased year on year consistent with the increase in the over 64 years old population. Vitrectomy surgery growth exceeded that of the national population, including those over 64 years., (© 2022. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Background: Ocular surface squamous neoplasia (OSSN) is a relatively rare disease with a low mortality and highly variable incidence. Despite a high incidence of OSSN in the Southern hemisphere, there is limited epidemiological data for New Zealand. The current study aims to assess the incidence, demographics, and histological grade of OSSN in the Waikato region of New Zealand, home to ~10% of the population of New Zealand., Methods: Non-interventional retrospective cohort study. All conjunctival biopsy histology reports from 2010 to 2019 in the Waikato region of New Zealand were analysed. Age, sex, and ethnicity were analysed and the incidence of OSSN was calculated. Main outcome measures included histological grade, rate of recurrence, and incidence of OSSN., Results: A total of 386 patients underwent conjunctival biopsy with histology during the study period. Eighty-three lesions (22%) involving 80 patients (21%) were reported positive for OSSN. Patients with OSSN had a mean age of 68.9 years (SD = 13.2), were predominantly male (76%), and of New Zealand-European ethnicity (53%). Conjunctival intraepithelial neoplasia-1 (30%) was the most frequent diagnosis. Three patients (4%) had recurrent lesions requiring repeat biopsy. The peak annual OSSN incidence rate was 3.81/100,000 population in 2019. The overall ten-year incidence was 2.13/100,000 population/year., Conclusion: This is the largest study to investigate OSSN incidence in New Zealand. The incidence rate of OSSN is one of the highest rates reported in the literature., (© 2021. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.)

Objectives: The aims of this case series are to (1) highlight the incidence of deliberate corrosive fluid injuries (DCFI) in East London; (2) ascertain the types of substances used; and (3) grade the resulting ocular surface burns using two validated grading systems., Methods: The Metropolitan Police 2017 Freedom of Information (FOI) requests were reviewed for DCFI. We retrospectively reviewed patient records between October 2016 and 2017 from local A&E departments for DCFI. Roper-Hall and Dua Classifications were used to classify prognoses in patients with deliberate ocular corrosive fluid injuries (DOCFI)., Results: The FOIs demonstrated an increasing trend with the highest number of DCFI surrounding our centre. We identified 57 patients with DCFI. Based on pre-irrigation pH measurement, 54.4% (n = 31) sustained acidic; 21.1% (n = 12) alkaline and 24.6% (n = 14) unknown injuries. More than half, 66.7% (n = 38), sustained DOCFI with median presentation visual acuity (VA) 0.25 LogMAR (n = 26, IQR: 0.10-0.39) and 1 month VA 0.20 LogMAR (n = 16, IQR: 0.02-0.20). Prognosis of the worse eye using (1) Roper-Hall Classification was 55% good (Grade I-II); 23% guarded (Grade III); 23% guarded (Grade IV); and (2) Dua Classification was 23% very good (Grade I); 35% good (Grade II-III); 19% good to guarded (Grade IV); 23% guarded to poor (Grade V); and 0% very poor (Grade VI)., Conclusions: DCFI mostly affected young men in this cohort. Our clinical experience suggested an alarming increase in DCFI and is supported by police data. Although this patient group appears to show relatively good outcomes, legislation to prevent these attacks should be prioritised.