The Impact of "One-Stop Shopping" on Competitive Store Brand Strategy

AbstractPurpose To investigate whether new classesof glaucoma medication have influencedglaucoma filtration surgery over a 20-yearperiod in the southeast region of Ireland.Methods All patients undergoing glaucomafiltration surgery between January 1986 andDecember 2005 in Waterford RegionalHospital were identified. The following datawere recorded for each patient: age; sex; andtype of filtration procedure.Results Over the 20-year study period twoconsultant ophthalmic surgeons performed atotal of 760 glaucoma filtration procedures onpatients aged over 20 years. The annualaverage number of glaucoma surgeriesdeclined steadily, defined by availability ofdifferent topical anti-glaucoma medications,from an average of 23.75 surgeries per surgeonper year in the subperiod 1986–1995, to 21 in1996, 20 in 1997, and 12.69 surgeries persurgeon per year in 1998–2005, thesedifferences being statistically significant(general linear model, Po0.001). The ageprofile of patients did not change significantlyover the course of the study period.Conclusions The volume of patientsrequiring glaucoma filtration surgery underthe care of two consultant ophthalmicsurgeons decreased over the 20-year studyperiod, an era in which three classes of anti-glaucoma medications were made available.However, an increase in the age profile ofpatients undergoing glaucoma filtrationsurgery during the same period was notobserved. Further study is required to resolvewhether introduction of the new topicalanti-glaucoma medications has led to a realreduction in the demand for glaucomafiltration surgery, or has just led to the deferralof such a demand.Eye (2009) 23, 1675–1680; doi:10.1038/eye.2008.335;published online 31 October 2008Keywords: glaucoma medication; geographic;trabeculectomyIntroductionGlaucoma, one of the most common causes ofblindness worldwide, may be defined as ‘acharacteristic form of optic neuropathy, withsome regard to intraocular pressure.’