Cost-minimization analysis of capsulotomy after ECCE and IOL implantation

Abstract

An economic evaluation of capsulotomy for posterior capsular opacification after extracapsular cataract extraction (ECCE) and intraocular lens (IOL) implantation was carried out using a cost minimization model. This model demonstrates the use of cost comparison to aid the decision making process. A flow-chart of capsulotomy mode, with associated complications, is illustrated. Costs of complications are calculated using assigned probability for each tree. Overall comparative costs are displayed graphically. Further, the model is presented using a computer-assisted spreadsheet with an added calculation program. Variables can therefore be adjusted with instantaneous outcomes visually displayed. We present several examples with different sets of variables and find that, in most instances, YAG capsulotomy is a more economical option than surgical capsulotomy. This finding is a relevant finding in planning for eye health programs, particularly in developing countries. We suggest that the model be modified using local parameters in order to provide optimal benefits in similar health programs.