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Title: Cost-effectiveness of descemet's stripping endothelial keratoplasty versus penetrating keratoplasty
Authors: Bose, S.
Ang, M.
Mehta, J.S. 
Tan, D.T.
Finkelstein, E.
Issue Date: Mar-2013
Citation: Bose, S., Ang, M., Mehta, J.S., Tan, D.T., Finkelstein, E. (2013-03). Cost-effectiveness of descemet's stripping endothelial keratoplasty versus penetrating keratoplasty. Ophthalmology 120 (3) : 464-470. ScholarBank@NUS Repository.
Abstract: Purpose: Selective endothelial transplantation in the form of Descemet's stripping endothelial keratoplasty (DSEK) is rapidly replacing traditional full-thickness penetrating keratoplasty (PK) for endothelial disease. An incremental cost-effectiveness analysis was performed to determine whether the benefits of DSEK are worth the additional costs. Design: Retrospective cohort study. Participants: Patients at the Singapore National Eye Center, a tertiary eye center in Singapore, with Fuchs' dystrophy or bullous keratopathy who underwent either PK or DSEK. Intervention: Patients underwent either PK (n = 171) or DSEK (n = 93) from January 2001 through December 2007. Data were collected from inpatient and outpatient notes corresponding to the time immediately before the procedure to up to 3 years after. Main Outcome Measures: Improvements in best spectacle-corrected visual acuity were used to calculate the increase in quality-adjusted life years (QALYs) 3 years after the procedure. This was combined with hospital charges (a proxy for costs) to determine incremental cost-effectiveness ratios (ICERs) comparing PK with no intervention and DSEK with PK. Results: Three-year charges for DSEK and PK were $7476 and $7236, respectively. The regression-adjusted improvement in visual acuity for PK relative to no intervention was -0.613 logarithm of the minimum angle of resolution (logMAR) units (P
Source Title: Ophthalmology
ISSN: 01616420
DOI: 10.1016/j.ophtha.2012.08.024
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