Characterizing the Modern Interventional Glaucoma Treatment Paradigm: The Newton Registry

INTRODUCTION: We aim to describe the development of the Newton Registry which characterizes the frequency and nature of interventional glaucoma (IG) procedures used for treatment in the USA between 2022 and 2025. METHODS: The Newton Registry contains International Classification of Disease Tenth Edition (ICD-10) codes and Current Procedural Terminology (CPT) codes from encounters with patients with glaucoma and providers in ophthalmology practices in the USA. Each practice provided a window of data 18-36 months in duration that captured all glaucoma patient and procedure encounters of the practice's providers. Robust data cleaning techniques were applied. Analyses were descriptive in nature and included a qualitative description of the dataset and its structure, the types and severity of glaucoma included, the duration of follow-up and lapse rate, and the frequency and nature of therapeutic IG. RESULTS: The Registry contains data from 724,728 encounters between 157,246 patients with glaucoma and 605 providers at 35 practices. Most patients had open-angle glaucoma (82.1%) or were glaucoma suspects (10.5%). The glaucoma was coded as mild in 51.8% of patients, moderate in 13.5%, and severe in 17.8%. The mean follow-up duration was 15.4 (10.7) months with 56.3% having a > 12-month lapse in glaucoma care during the 18-36 month observation window. The glaucoma procedures rate (≥ 1 procedure during the observation window) was 12.2%; common procedures included selective laser trabeculoplasty (44.4%), stent implantation (25.7%), canaloplasty (12.3%), and goniotomy (12.1%), as well as traditional filtering surgeries (4.5%). CONCLUSIONS: The Newton Registry provides important information on current glaucoma treatment practice patterns. In subsequent analyses, this dataset may reveal the current status of the use of IG, provide insight into how IG is currently being deployed, supply a standard against which practices can compare when examining their own treatment patterns, and establish a baseline against which future changes in practice patterns can be measured.