March 2012
Volume 53, Issue 14
ARVO Annual Meeting Abstract  |   March 2012
Cost-effectiveness Analysis Of Immediately Sequential Bilateral Cataract Surgery
Author Affiliations & Notes
  • Monali Malvankar
    Ophthalmology, University of Western Ontario, LONDON, Ontario, Canada
  • William Hodge
    Ophthalmology, University of Western Ontario, LONDON, Ontario, Canada
  • Footnotes
    Commercial Relationships  Monali Malvankar, None; William Hodge, None
  • Footnotes
    Support  Canadian National Institute for the Blind
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 6663. doi:
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      Monali Malvankar, William Hodge; Cost-effectiveness Analysis Of Immediately Sequential Bilateral Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6663.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : Cataract is responsible for 48% of world blindness, which represents 18 million people according the World Health Organization. Due to inadequate surgical services in developing countries, cataract remains a leading cause of blindness. Even in developed countries where adequate surgical services are available, cataract may still be prevalent due to long waiting time for operations and associated cost. To enhance cataract surgical productivity and to reduce associated health care cost, immediately sequential bilateral cataract surgery (ISBCS), the cataract surgery that is performed in both eyes simultaneously, can be a plausible solution for patients needing surgery in both the eyes compared to delayed sequential bilateral cataract surgery (DSBCS), the surgery that is performed in each eye on a different day as a completely separate operation. The purpose of our project is to perform a cost-effectiveness analysis of ISBCS to answer the following questions. Is ISBCS, an appropriate cost effective way to rapidly rehabilitate patient’s visual impairment? If yes, should ISBCS be offered routinely to patients with bilateral visually significant cataract?

Methods: : We performed meta-analysis using EPPI Reviewer 4 and STATA. For the economic analysis, we constructed a decision analytic model from the public third-party (Ministry of Health) payer’s perspective. The economic analysis consisted of cost-effectiveness analysis in which the cost and the effectiveness of both the surgeries, ISBCS and DSBCS, were compared. A study population consisted of adults with bilateral cataract surgery. Cost data consisted of the cost of the surgery from London Health Science Center-case costing system. The effectiveness was measured by the number of cases of vision of 20/40 or better.

Results: : The primary outcome measure was quality adjusted life years (QALYs) based on the conducted systematic review. We performed probabilistic sensitivity analysis using Crystal Ball Software to evaluate the robustness of the base-case results.

Conclusions: : Our research is the first step in performing such health economics assessment of ISBCS and the results of this economic evaluation will be useful for policy makers, clinicians, hospital administrators, and payers in order to put forward a protocol for performing ISBCS.

Keywords: cataract • clinical (human) or epidemiologic studies: health care delivery/economics/manpower • quality of life 

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