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Cataract surgery is cost-effective for advanced glaucoma patients over time
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Researchers found that cataract surgery is a cost-effective treatment for advanced glaucoma patients of average means in Shanghai in terms of their life expectancy, with the increase in visual acuity improving their quality of life, according to a study by Xian Xu, MM, and colleagues in the Journal of Glaucoma.
A total of 93 patients with advanced glaucoma underwent cataract surgery with 3 months of follow-up. Mean patient age was 69.10 years.
The single surgeon used a standard phacoemulsification technique.
Researchers found the mean incremental cost of cataract surgery using the time trade-off method.
Quality-adjusted-life-years (QALY) were determined using the patients’ life expectancy at a 3% discounted rate, according to researchers.
The mean incremental cost of cataract surgery was $1,593, with an average of 2.20 additional QALY.
As life expectancy is rising, the researchers assume a higher number of QALYs can be predicted with lessening in costs over a longer period of time.
“These results can provide evidence to both doctors and patients that cataract surgery is effective in advanced glaucoma patients who have IOP stability, accept cataract surgery alone and have no severe intraoperative or postoperative complications,” the researchers wrote. – by Abigail Sutton
Disclosure: The researchers reported no relevant financial disclosures.
Perspective
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Carl H. Jacobsen, OD, FAAO
Cataracts and glaucoma are common eye conditions that often coexist in our elderly patients. Interestingly, as Dr. Scott Anthony mentioned in his perspective, topical glaucoma treatment affects cataractogenesis and may increase cataract surgery complication rates.
Is it advantageous for advanced glaucoma patients to have cataract surgery? Xu and colleagues suggest the answer to this question is “yes.”
Data collected via patient survey are often considered to lack scientific rigor. However, because glaucoma preferentially affects peripheral vision, even in advanced cases, and because cataracts most often produce symptoms by decreasing central vision, it makes intuitive sense that glaucoma patients are pleased with their cataract surgery results. Importantly, this paper also suggests that cataract surgery is a cost-effective procedure.
Considering the additional facts that cataract surgery is known to result in IOP lowering and that microinvasive glaucoma surgeries are often performed at the time of cataract surgery, there is ample evidence that we should be recommending cataract surgery for our advanced glaucoma patients with visually significant cataract.
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