AIM: To analyze the number of laser peripheral iridotomies (LPIs) performed from 2000 to 2021 in the United States.

MATERIALS AND METHODS: The Centers for Medicare and Medicaid Services Part B National Summary database was queried to obtain deidentified records of patients who underwent LPI between 2000 and 2021, and patients who underwent cataract surgery between 2011 and 2021. Annual total allowed services and charges were collected for CPT 66761 (LPI), and CPT 66982 and 66984 (cataract surgery). Annual inflation rates and population data were obtained from the US Bureau of Labor Statistics and the World Bank.

RESULTS: The number of LPIs performed increased 58.8% from 64,935 in 2000 to 1,03,113 in 2008, remained fairly constant between 2009 and 2015, and declined 35.4% from 96,495 in 2016 to 62,376 in 2021. Allowed services per 10,000 people increased 47.37% from 2.301 in 2000 to 3.391 in 2008 before declining 44.59% to 1.879 in 2021. The US population increased 17.6% over the time period. LPI average allowed charge was $311.71 in 2000, increased to $376.77 in 2007, decreased to $269.88 in 2012, remained relatively constant from 2012 to 2018, and increased from $275.47 in 2019 to $280.33 in 2021. The average allowed charge decreased 10.1%, while the rate of cumulative inflation was 53%. Total annual allowed charge decreased 13.6% from 2000 to 2021, unadjusted for inflation.

CONCLUSION: From 2000 to 2021, the number of LPIs performed in the United States declined while population increased. Potential drivers include results of scientific studies that recommended early cataract surgery and observing patients with primary angle closure suspects (PACS), a shift in physician sentiment of the LPI risk-benefit ratio, and economic forces. Finally, the COVID-19 pandemic may have contributed to the decrease in LPIs in 2020 and 2021.

CLINICAL SIGNIFICANCE: The number of LPIs performed in the United States declined over the last 20 years, while the population has increased. Factors, such as influential studies recommending early cataract extraction and monitoring patients without LPI, shifting doctor sentiments, and economic factors may have affected LPI rates.

HOW TO CITE THIS ARTICLE: Maheshwari A, Sarrafpour S, Jayaram R, Quantification and Analysis of Laser Peripheral Iridotomies in the United States from 2000 to 2021. J Curr Glaucoma Pract 2025;19(4):208-215.