Microcosting of Cataract Surgery Complications from a US Provider Perspective

Author(s)

Woodard L1, Lubeck D2, Hsiao C3, Pan SM4, Son D5, Zhou A5, Miller K6
1Omni Eye Services of Atlanta, Atlanta, GA, USA, 2Arbor Centers for EyeCare, Homewood, IL, USA, 3Alcon Inc., Chicago, IL, USA, 4Alcon Vision LLC, West Covina, CA, USA, 5EVERSANA, Burlington, ON, Canada, 6University of California, Los Angeles, Los Angeles, CA, USA

OBJECTIVES: The costs associated with complications during and following cataract surgery are not well documented in the literature. This study aimed to determine the routine treatment of cataract surgery complications through discussions with an expert panel, and to determine the costs of the complications from a US provider perspective through a microcosting approach.

METHODS: Three US ophthalmologists were interviewed about the additional operating room (OR) time and materials required to treat complications intraoperatively, and additional clinical visits and procedures required for postoperative treatment. Input from the three experts was used to microcost five complications from the US provider perspective: posterior capsule rupture (PCR), corneal burn, cystoid macular edema (CME), corneal edema, and elevated intraocular pressure (IOP). Costs were estimated based on published literature, where available, and costs/payments reported by the Centers for Medicare and Medicaid Services. Costs are reported in 2021 US dollars.

RESULTS: Cost per patient was calculated. The cost of PCR was $1,776, including additional OR time (39 minutes) and materials, and additional physician visits, imaging, and procedures (eg, laser vitreolysis). The cost of corneal burn ranged from $35 (mild) to $716 (severe), including additional OR time (up to 27 minutes) and materials, and additional physician visits. The cost of CME, corneal edema, and elevated IOP ranged from $64 (mild) to $133 (severe), $12 (mild) to $121 (severe), and $0 (mild) to $230 (severe), respectively, including additional physician visits and procedures (eg, paracentesis).

CONCLUSION: Intraoperative complications (PCR and corneal burn) were associated with the highest costs to providers due to the additional OR time and materials required. Providers also incur costs related to additional follow-up visits and procedures for both intraoperative and postoperative complications. This study addresses the current literature gap and can be used to inform future economic analyses for interventions designed to reduce cataract surgery complications.

Conference/Value in Health Info

2022-05, ISPOR 2022, Washington, DC, USA

Code

EE362

Topic

Economic Evaluation, Study Approaches

Topic Subcategory

Surveys & Expert Panels

Disease

Surgery

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