Purchase this article with an account.
Mirjam Meltzer, Van C Lansingh, Ving Chan, Andreas Mueller, Ling Jin, Sasipriya Karumanchi, Chunhong Guan, Alemayehu Sisay, Steven Kymes, Nathan G Congdon; Costs of follow-up visit and uptake of glasses and complication treatment after cataract surgery in developing countries: PRECOG, a multi-center observational study. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1672.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Follow-up rates after cataract surgery in developing areas are often low. It has recently been shown that early assessment of vision after surgery is an accurate indicator of outcome quality. We sought to estimate possible glasses uptake, uptake of treatment of complications and the costs of post-cataract surgery follow-up in developing countries.
A total of 27 hospitals in 8 countries in Africa, Asia and Latin America each recruited 40-120 consecutive surgical cataract patients. Patients were examined >=40 days post-operatively, either spontaneously at hospital, after telephone calls or transport subsidies, or via home visits. Data were collected on post-operative complications potentially correctable by surgery or medication, distance vision improvable by >=2 lines with refraction, and patient and hospital costs for follow-up adjusted for published purchasing power parity.
Among 2487 patients recruited, 2316 had follow-up (93%), at which time 48% would benefit from glasses, of whom 52.3% would pay for them. Among patients with a complication (2.4%), 48.6% were treatable and 88.9% would accept treatment. The number of patients needed to examine to find one benefitting from and accepting glasses was 4 and for complications this was 95. Total (patient+hospital) costs for a spontaneous follow-up visit ranged from USD21 (Vietnam) to 122 (Mexico), while home visits were 70% more expensive. Average price of glasses ranged from USD22-250 and postoperative treatment from USD114-580. If home visits were not included, approximately 6% of all patients that would accept glasses or treatment would have been missed.
This is the first large study investigating the costs of a follow-up visit and acceptance rate of glasses and treatment of complications after cataract surgery in developing countries where follow-up is low. Although complications were rare, a quarter of patients would benefit from a follow-up visit to have spectacles fitted. Costs for a follow-up visit vary widely among countries.
This PDF is available to Subscribers Only