Cost-Effectiveness Analysis of Cataract Surgery for the Beginners Using Intraocular Illumination

Purpose: To evaluate the cost-effectiveness of cataract surgery for the beginners using intraocular illumination compared to the case of using microscope illumination.Methods: A Markov model was constructed for cost-effectiveness analysis. Hypothetical Korean men and women over 50 years of age were set as a cohort, and cataract surgeons were limited to beginners with less than 2 years of experience. Cataracts were classified as severe cataracts requiring surgery and mild cataracts that did not require surgery. Cataracts was assumed to progress to severe cataracts in 10% of each year. A cost-effectiveness analysis was performed based on the difference in the complications of surgery according to intraocular and microscope illumination. For the cost, data from the National Health Insurance Corporation were used, and a micro cost calculation method was used. In the utility analysis, data from previous studies were used for utility in each cataract and complication status. Sensitivity analysis was performed to evaluate the uncertainty of the results.Results: The surgery using microscope intraocular illumination showed the cost of 3,168,895 won, and the quality-adjusted life years of 16.4 years. The surgery of intraocular illumination showed the cost of 3,200,552 won and the quality-adjusted life years of 16.5 years. the incremental cost-effectiveness ratio of intraocular illumination was 1,675,630 won compared to microscope illumination. In the sensitivity analysis to, the utility of postoperative state without complication had the greatest influence on the results.Conclusions: For beginners with less than 2 years of surgical experience, the incremental cost-effectiveness ratio was 1,675,630 won, which is acceptable in Korea's health care system, when comparing the case of using intraocular illumination to the case of using conventional microscope illumination.