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Cost-utility analyses of cataract surgery in vision-threatening diabetic retinopathy.
J Cataract Refract Surg. 2017 01; 43(1):95-101.JC

Abstract

PURPOSE

To explore the cost utility of cataract surgery in patients with stabilized vision-threatening diabetic retinopathy (DR).

SETTING

Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China.

DESIGN

Prospective case series.

METHODS

Patients diagnosed with cataracts combined with stabilized vision-threatening DR had successful phacoemulsification with foldable posterior chamber intraocular lens implantation. The corrected distance visual acuity (CDVA) and utility value obtained using the time tradeoff method at 3-month postoperative intervals were compared with those preoperative values. The cost per quality-adjusted life year gained was calculated using the bootstrap method. Sensitivity analyses were performed to test the robustness of the results.

RESULTS

The study comprised 126 patients (153 eyes). All surgeries were successful. The weighted logMAR CDVA changed from 0.82 logMAR ± 0.34 (SD) to 0.58 ± 0.30 logMAR (P < .001). The utility values increased from 0.58 ± 0.14 to 0.72 ± 0.14 (P < .001). The gain in utility values was correlated with the postoperative weighted logMAR CDVA, the change between the postoperative and preoperative weighted logMAR CDVA, performance of bilateral cataract surgery, and duration of DR or diabetic macular edema. The patients gained 1.50 quality-adjusted life years by cataract surgery. The cost per quality-adjusted life year was US $768. This surgery was cost-effective at the threshold of US $22 526 per quality-adjusted life year in China. The cost per quality-adjusted life year varied from US $630 to US $8707 in sensitivity analyses.

CONCLUSION

Cataract surgery was a cost-effective intervention for patients with coexisting, stabilized, vision-threatening DR.

Authors+Show Affiliations

From the Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China.From the Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China.From the Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China. Electronic address: zouhaidong@hotmail.com.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28317685

Citation

Zhu, Bijun, et al. "Cost-utility Analyses of Cataract Surgery in Vision-threatening Diabetic Retinopathy." Journal of Cataract and Refractive Surgery, vol. 43, no. 1, 2017, pp. 95-101.
Zhu B, Ma Y, Zou H. Cost-utility analyses of cataract surgery in vision-threatening diabetic retinopathy. J Cataract Refract Surg. 2017;43(1):95-101.
Zhu, B., Ma, Y., & Zou, H. (2017). Cost-utility analyses of cataract surgery in vision-threatening diabetic retinopathy. Journal of Cataract and Refractive Surgery, 43(1), 95-101. https://doi.org/10.1016/j.jcrs.2016.10.023
Zhu B, Ma Y, Zou H. Cost-utility Analyses of Cataract Surgery in Vision-threatening Diabetic Retinopathy. J Cataract Refract Surg. 2017;43(1):95-101. PubMed PMID: 28317685.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-utility analyses of cataract surgery in vision-threatening diabetic retinopathy. AU - Zhu,Bijun, AU - Ma,Yingyan, AU - Zou,Haidong, PY - 2016/07/11/received PY - 2016/09/10/revised PY - 2016/10/25/accepted PY - 2017/3/21/entrez PY - 2017/3/21/pubmed PY - 2019/10/17/medline SP - 95 EP - 101 JF - Journal of cataract and refractive surgery JO - J Cataract Refract Surg VL - 43 IS - 1 N2 - PURPOSE: To explore the cost utility of cataract surgery in patients with stabilized vision-threatening diabetic retinopathy (DR). SETTING: Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China. DESIGN: Prospective case series. METHODS: Patients diagnosed with cataracts combined with stabilized vision-threatening DR had successful phacoemulsification with foldable posterior chamber intraocular lens implantation. The corrected distance visual acuity (CDVA) and utility value obtained using the time tradeoff method at 3-month postoperative intervals were compared with those preoperative values. The cost per quality-adjusted life year gained was calculated using the bootstrap method. Sensitivity analyses were performed to test the robustness of the results. RESULTS: The study comprised 126 patients (153 eyes). All surgeries were successful. The weighted logMAR CDVA changed from 0.82 logMAR ± 0.34 (SD) to 0.58 ± 0.30 logMAR (P < .001). The utility values increased from 0.58 ± 0.14 to 0.72 ± 0.14 (P < .001). The gain in utility values was correlated with the postoperative weighted logMAR CDVA, the change between the postoperative and preoperative weighted logMAR CDVA, performance of bilateral cataract surgery, and duration of DR or diabetic macular edema. The patients gained 1.50 quality-adjusted life years by cataract surgery. The cost per quality-adjusted life year was US $768. This surgery was cost-effective at the threshold of US $22 526 per quality-adjusted life year in China. The cost per quality-adjusted life year varied from US $630 to US $8707 in sensitivity analyses. CONCLUSION: Cataract surgery was a cost-effective intervention for patients with coexisting, stabilized, vision-threatening DR. SN - 1873-4502 UR - https://www.unboundmedicine.com/medline/citation/28317685/Cost_utility_analyses_of_cataract_surgery_in_vision_threatening_diabetic_retinopathy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0886-3350(16)30577-6 DB - PRIME DP - Unbound Medicine ER -