July 2019


Journal of Cataract & Refractive Surgery
In the journal: July 2019

A cost-utility analysis of 2018 cataract surgery in the United States

Gary Brown, MD, Melissa Brown, MD, Brandon Busbee, MD
How cost effective is cataract surgery? A recent study examined cost utility of this in 2018 in the United States. Investigators found that when a cataract was removed from the first eye there was a 33.3% patient value gain and a 25.5% gain in quality of life. With bilateral surgery patient value gain was 44.1%, with an 8.1% gain for the second eye surgery alone. While there was a gain of 2.52 quality-adjusted life years (QALY) for cataract surgery in the first eye, the incremental gain for the second eye was 0.81. For the first eye the cost-utility ratio was $1,001 per QALY and for the second eye was $3,101, while for bilateral cataract surgery this was $1,514. Investigators found that the net return on investment for first-eye cataract surgery over a 14-year period was $370,018 above the $2,526 spent for the surgery. They concluded that cataract surgery is highly cost effective in both the first and second eyes.

Perioperative considerations and anesthesia management in patients with obstructive sleep apnea undergoing ophthalmic surgery – focused and narrative review

Oya Cok, MD, Edwin Seet, MB BS, Chandra Kumar, MB BS, Girish Joshi, MD
In this literature review, investigators examined obstructive sleep apnea and its prevalence in various ophthalmic conditions. They found that patients with this disorder marked by cessation of breathing resulting from upper airway obstruction during sleep had an increased prevalence of some ophthalmic disorders. Such disorders included glaucoma, cataract, keratoconus, eye lid laxity, central serous retinopathy, and non-arteritic anterior ischemic optic neuropathy. Investigators pointed out that some of these conditions may require surgery and that more than 80% of surgical patients with sleep apnea are unrecognized. They recommend that screening for obstructive sleep apnea be done in all surgical patients. Investigators urged that comorbid conditions associated with obstructive sleep apnea such as hypertension, obesity, diabetes, arrhythmias, heart failure, and stroke be optimized prior to surgery. The review also highlighted best perioperative anesthesia practices in this population.

Corneal higher order aberration measurement comparison between Scheimpflug and dual Scheimpflug/Placido technology in keratoconic eyes

Andre Piccinini, MD, Oren Golan, MD, Emilio Torres-Netto, MD, Farhad Hafezi, MD,
J. Bradley Randleman, MD

The aim of this retrospective study was to compare use of the Scheimpflug and dual Scheimpflug/Placido devices. Included were 50 eyes of 50 patients. Investigators found that both spherical aberration and total root mean square were significantly different with these instruments with trefoil at 30 degrees. Meanwhile, total coma values did not differ when trefoil was at 0 degrees and there was weak positive correlation between the devices. At 30 degrees there was moderate positive correlation. Strong positive correlation was also seen for horizontal coma (r=0.430), vertical coma (r=0.816), spherical aberration (r=0.874), and total corneal root mean square (r=0.874). Investigator concluded that in patients with keratoconus, measurements generated by the Scheimpflug and dual Scheimpflug/Placido devices should not be considered equivalent; corneal higher order aberrations measured with these showed some significant differences.

In the journal: July 2019 In the journal: July 2019
Ophthalmology News - EyeWorld Magazine
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