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G.P. Matthews, J. Schmier, M. Halpern, D. Covert; Evaluation of Costs for Cystoid Macular Edema Among Patients Following Cataract Surgery . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4409.
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© ARVO (1962-2015); The Authors (2016-present)
Cystoid macular edema (CME) is an important complication associated with cataract surgery, but little is known about its costs. This analysis estimates the cost of treatment for cystoid macular edema in the United States.
Data were analyzed from the 1997 through 2001 Medicare 5% Beneficiary Encrypted Files. Beneficiaries who underwent cataract surgery were identified and stratified by diagnosis of CME (cases) or no diagnosis of CME (controls) within one year following surgery. Baseline and clinical characteristics at time of surgery were determined. Claims and reimbursements for ophthalmic care were identified. Subgroup analyses explored the cost of CME among beneficiaries with vs. without diabetes.
Among 139,759 Medicare beneficiaries followed for at least 12 months after cataract surgery, 2,720 were diagnosed with CME. Approximately 16% of these cataract patients had diabetes (n=23,122) and 706 of this subgroup also had CME. In contrast, 2,014 cataract patients without diabetes (n=116,637) were diagnosed with CME. Annual total ophthalmic claims were $3,298 higher for cases compared to controls; payments were $1,092 higher. The percent increase in claims and payments due to CME were similar for diabetic and non–diabetic patients.
These findings demonstrate a substantial cost associated with CME. Therapies that successfully prevent or decrease the severity of CME are likely to result in substantial cost and resource savings, particularly among beneficiaries with diabetes. Further analyses should explore the relationship of concomitant conditions to costs among patients with CME.
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