Is it clinically and cost effective to perform second-eye cataract surgery in the absence of other ocular co-morbidities in patients who have already had first-eye surgery?
Kelly J, Emengo H
Record ID 32013000480
English
Authors' recommendations:
Summary
The findings from two RCTs suggest that second-eye surgery in people with bilateral cataract without severe ocular co-morbidities, compared with surgery in one eye only, can result in improvements in outcomes such as VA, stereopsis, patient-reported visual disability and confidence. However, one of the trials was unable to demonstrate that second-eye surgery reduces the risk of falling.
Of the three cost-utility studies identified, only one was UK-based. The results suggest that in people who have minor preoperative visual dysfunction, second-eye cataract surgery is not likely to be cost-effective in the short term. However, the authors also report that in the long-term, cataract surgery appears to be cost-effective in this patient group if carer costs are not included. A Finnish study included a similar patient group (ie people who reported that they had minor seeing problems preoperatively), and reported a reduction (not significant) in HRQoL after second-eye surgery.
An American-based cost-utility analysis concluded that 'second-eye cataract surgery is an extremely cost-effective procedure'.
The difference in results, compared with the other studies, may be because the patient populations were different (it is not clear whether the different data sources in the American study relate to the same population). Further, the American study derived utilities from general ophthalmic patients, rather than
people with cataracts themselves.
Details
Project Status:
Completed
Year Published:
2012
URL for published report:
http://www.healthcareimprovementscotland.org/our_work/technologies_and_medicines/shtg_scoping_reports/technologies_scoping_report_8.aspx
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Scotland, United Kingdom
MeSH Terms
- Humans
- Cataract Extraction
- Ophthalmologic Surgical Procedures
Contact
Organisation Name:
Scottish Health Technologies Group
Contact Address:
Scottish Health Technologies Group, Delta House, 50 West Nile Street, Glasgow, G1 2NP Tel: 0141 225 6998
Contact Name:
his.shtg@nhs.scot
Contact Email:
his.shtg@nhs.scot
Copyright:
Healthcare Improvement Scotland
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.