title: Cost-effectiveness of retinal detachment repair.
abstract: OBJECTIVE
  To evaluate costs and treatment benefits of rhegmatogenous retinal detachment (RD) repair.
  
  
  METHODS
  A Markov model of cost-effectiveness and utility.
  
  
  METHODS
  There were no participants.
  
  
  METHODS
  Published clinical trials (index studies) of pneumatic retinopexy (PR), scleral buckling (SB), pars plana vitrectomy (PPV), and laser prophylaxis were used to quantitate surgical management and visual benefits. Markov analysis, with data from the Center of Medicare and Medicaid Services, was used to calculate the adjusted costs of primary repair by each modality in a hospital-based and ambulatory surgery center (ASC) setting.
  
  
  METHODS
  Lines of visual acuity (VA) saved, cost of therapy, adjusted cost of therapy, cost per line saved, cost per line-year saved, and cost per quality-adjusted life years (QALY) saved.
  
  
  RESULTS
  In the facility, hospital surgery setting, weighted cost for PR ranged from $3726 to $5901 depending on estimated success rate of primary repair. Weighted cost was $6770 for SB, $7940 for PPV, and $1955 for laser prophylaxis. The dollars per line saved ranged from $217 to $1346 depending on the procedure. Dollars per line-year saved ranged from $11 to $67. Dollars per QALY saved ranged from $362 to $2243. In the nonfacility, ASC surgery setting, weighted cost for PR ranged from $1961 to $3565 depending on the success rate of primary repair. The weighted costs for SB, PPV, and laser prophylaxis were $4873, $5793, and $1255, respectively. Dollars per line saved ranged from $139 to $982. The dollars per line-year saved ranged from $7 to $49, and the dollars per QALY saved ranged from $232 to $1637.
  
  
  CONCLUSIONS
  Treatment and prevention of RD are extremely cost-effective when compared with other treatment of other retinal diseases regardless of treatment modality. Retinal detachment treatment costs did not vary widely, suggesting that providers can tailor patient treatments solely on the basis of optimizing anticipated results because there were no overriding differences in financial impact.
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Chang
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida. Electronic address: wsmiddy@med.miami.edu.
authors.forename: William E
authors.initials: WE
authors.lastname: Smiddy
mesh_terms: D003362:Cost-Benefit Analysis; D003452:Cryosurgery / Q000191:economics*; D017048:Health Care Costs; D006801:Humans; D053685:Laser Therapy / Q000191:economics*; D008390:Markov Chains; D008875:Middle Aged; D019057:Quality-Adjusted Life Years; D012163:Retinal Detachment / Q000191:economics* / Q000503:physiopathology / Q000601:surgery; D012591:Scleral Buckling / Q000191:economics*; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy / Q000191:economics*