Is first eye cataract surgery cost effective?

First eye cataract surgery is probably more cost-effective over a patient's remaining lifetime than if they have no surgery at all, according to a study published in the December issue of the British Journal of Ophthalmology.

Tracey Sach and colleagues from the University of East Anglia, UK evaluated the cost-effectiveness of first eye cataract surgery compared with no surgery from a health service and personal social services perspective. A sample of 306 women aged 70 years or older with bilateral cataracts were randomized to cataract surgery (expedited) or control (routine 12-month wait for surgery).

The operated group cost a mean £2,004 (approx. €2,800) more than the control group over one year. However, they experienced an average 0.456 fewer falls, an incremental cost per fall prevented of £4,390 (approx. €6,150). The mean gain in quality of life years (QALYs) per patient was 0.056. The incremental cost-utility ratio was £35,704 (approx. €50,000), above the currently accepted UK threshold level of willingness to pay per QALY of £30,000 (approx. €42,000). However, in an analysis modelling costs and benefits over a patients' expected lifetime, the incremental cost per QALY was £13,172 (approx. €18,500) under conservative assumptions.

According to the researchers, although first eye cataract surgery was not cost-effective over the trial period, it is probably more cost-effective over a patients' remaining lifetime, than if they had no surgery at all.