title: Cost effectiveness of the type II Boston keratoprosthesis.
abstract: OBJECTIVE
  Despite demonstrated cost effectiveness, not all corneal disorders are amenable to type I Boston keratoprosthesis (KPro) implantation. This includes patients with autoimmune diseases, such as Stevens-Johnson syndrome/toxic epidermal necrolysis. Type II KPro is implanted through the eyelids in severe dry eye and cicatricial diseases, and its cost effectiveness was sought.
  
  
  METHODS
  In a retrospective chart review, 29 patients who underwent type II KPro surgery at the Massachusetts Eye and Ear Infirmary between the years 2000 and 2009 were identified. A total of 11 patients had 5-year follow-up data. Average cost effectiveness was determined by cost-utility analysis, comparing type II KPro surgery with no further intervention.
  
  
  RESULTS
  Using the current parameters, the cost utility of KPro from third-party insurer (Medicare) perspective was 63,196 $/quality-adjusted life year .
  
  
  CONCLUSIONS
  Efforts to refer those less likely to benefit from traditional corneal transplantation or type I KPro, for type II KPro surgery, may decrease both patient and societal costs.
authors.affiliation: Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA. jaredament@post.harvard.edu
authors.forename: J D
authors.initials: JD
authors.lastname: Ament
authors.forename: T P
authors.initials: TP
authors.lastname: Stryjewski
authors.forename: S
authors.initials: S
authors.lastname: Pujari
authors.forename: S
authors.initials: S
authors.lastname: Siddique
authors.forename: G N
authors.initials: GN
authors.lastname: Papaliodis
authors.forename: J
authors.initials: J
authors.lastname: Chodosh
authors.forename: C H
authors.initials: CH
authors.lastname: Dohlman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003315:Cornea / Q000601:surgery; D003316:Corneal Diseases / Q000191:economics* / Q000601:surgery; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures / Q000191:economics; D019736:Prostheses and Implants / Q000191:economics*; D019919:Prosthesis Implantation / Q000191:economics*; D012189:Retrospective Studies