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J.M. Martinez, S. Magaz, X. Badia, G. Berdeaux, J.L. Alio; Costs and Consequences of Lasik, Glasses and Contact Lenses in Mild to Moderate Myopia: A Spanish Societal Approach . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2659.
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Purpose: The aim of this study was to compare the costs and consequences of 3 ways to correct mild to moderate myopia: laser in situ keratomileusis (Lasik), glasses and contact lenses (CL). Methods: A Markov model compared the present value of Lasik, glasses and CL. Resource utilisation was collected at the Instituto Oftalmologico de Alicante on 40 patients; it included transportation, time spent, hotel, spectacles, CL, Lasik, cleaning stuff, visit to ophthalmologist/optometrist/optic centre, and adverse event linked to Lasik and CL. Time horizon varied from 10 to 30 years with a 5% discount rate. The economic perspective was the one of the Spanish society. Full sensitivity analyses were conducted. Results: Depending on the time horizon, Lasik saved from 18 to 278 Km against spectacles, and from 405 to 1436 Km compared to CL. The time spent to care for visual acuity was found similar between Lasik and CL but up to 1,180 additional hours were spent by CL wearers. Lasik saved from 4.69 to 12.07 spectacles and from 28 to 84 glasses cleaning packs, 18 to 50 visits to the optic centre in comparison to glasses and 41 to 117 when compared to CL. 4.7 to 12.2 visits dedicated to correct VA were saved with Lasik. The latter avoided 95 to 295 per 10,000 CL-related keratitis. CL were always more costly than Lasik which was always more costly than glasses: 1595 to 2521 euros were to be added to glasses to get Lasik from the former, and savings were from 2277 to 7905 euros in comparison to CL. The two main sensitive parameters were time horizon and discount rate. Conclusions: Based on the results of a Markov model, and resource utilisation estimated from a panel of 40 patients, our study found that Lasik was cost saving in comparison to CL and more expensive than glasses, although potential non monetary benefits of Lasik over glasses were not taken into account.
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