METHODS: Representative index studies were reviewed to quantitate the reduction of mean IOP and glaucoma medications for each surgical intervention in childhood glaucoma. A US perspective was adopted, using Medicare allowable costs to calculate cost/mm Hg IOP reduction ($/mm Hg) at 1y postoperatively.
RESULTS: At 1y postoperatively, the cost/mm Hg IOP reduction was $226/mm Hg for microcatheter-assisted circumferential trabeculotomy, $284/mm Hg for cyclophotocoagulation, $288/mm Hg for conventional ab-externo trabeculotomy, $338/mm Hg for Ahmed glaucoma valve, $350/mm Hg for Baerveldt glaucoma implant, $351/mm Hg for goniotomy, and $400/mm Hg for trabeculectomy.
CONCLUSIONS: Microcatheter-assisted circumferential trabeculotomy is the most cost-efficient surgical method to lower IOP in childhood glaucoma, while trabeculectomy is the least cost-efficient surgical method.
方法:回顾了代表性指标研究,以定量儿童青光眼的每种手术干预的平均眼压和青光眼药物的降低。采用了美国的观点,使用Medicare允许的费用来计算术后1y的成本/mmHg眼压降低($/mmHg)。
结果:术后1天,微导管辅助环状小梁切开术的成本/mmHg眼压降低为226美元/mmHg,睫状体光凝术为$284/mmHg,$288/mmHg用于常规的ab-externo小梁切开术,Ahmed青光眼瓣膜338美元/mmHg,$350/mmHg用于Baerveldt青光眼植入物,$351/mmHg的性腺切开术,和$400/mmHg小梁切除术。
结论:微导管辅助环状小梁切开术是降低儿童青光眼眼压的最具成本效益的手术方法,而小梁切除术是成本效益最低的手术方法。