Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-25T19:38:32.417Z Has data issue: false hasContentIssue false
  • English
  • Français

Modeling utility of second-eye cataract surgery

Published online by Cambridge University Press:  01 August 2004

Mats Lundström  and
Eva Wendel
Mats Lundström
Affiliation:
EyeNet Sweden
Eva Wendel
Affiliation:
EyeNet Sweden
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: To study the impact on public health in terms of utility of various proportions of first-eye and second-eye cataract surgery.

Methods: A model was used to study the impact on a population of a fixed cataract surgical rate (9,250 operations/1,000,000 people) with varying proportions of first-eye and second-eye cataract operations. The study population was the County of Blekinge with a known incidence of previous cataract surgery. The prevalence of cataract, the estimated need for cataract surgery, and the utility values were taken from the literature. The population was grouped by disability stage of cataract and previous cataract surgery in accordance with prevalence studies and data from a large national database on cataract surgery and patients' self-assessed visual function. The mortality rate was taken from real data for the study population.

Results: Given a fixed cataract surgical rate over a period of five years, a high percentage of second-eye cataract surgery (42 percent) resulted in a mean utility of 0.82239 in the population forty years of age and older and the corresponding number for a low percentage of second-eye cataract surgery (25 percent) was 0.82253. A high percentage of second-eye surgeries resulted in 421 more individuals who were well compared with a low percentage of second-eye surgeries. On the other hand, a low percentage of second-eye surgeries resulted in 152 fewer individuals with disability and 118 fewer individuals with dependence compared with a high percentage of second-eye surgeries.

Conclusions: A high frequency of first-eye cataract surgeries instead of second-eye surgeries affects more individuals and means an optimized improvement of utility in a population. This should be recommended if the cataract surgical rate is very insufficient. If the cataract surgical rate is high, more second-eye surgeries should be performed to optimize quality of life to as many as possible.

Keywords

Cataract surgeryPublic healthUtilityDisabilityDependence
Type
RESEARCH REPORTS
Information
International Journal of Technology Assessment in Health Care , Volume 20 , Issue 3 , August 2004 , pp. 361 - 367
Copyright
© 2004 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Brown GC, Sharma S, Brown MM, Kistler J. 2000 Utility values and age-related macular degeneration. Arch Ophthalmol. 118: 47– 51.Google Scholar
Busbee BG, Brown MM, Brown GC, Sharma S. 2002 Incremental cost-effectiveness of initial cataract surgery. Ophthalmology. 109: 606– 613.Google Scholar
Churchill AJ, Vize CJ, Stewart OG, Backhouse O. 2000 What factors influence cataract waiting time? Br J Ophthalmol. 84: 429– 431.Google Scholar
Chylack LT, Wolfe JK, Singer DM, et al. 1993 The lens opacities classification system III. Arch Ophthalmol. 111: 831– 836.Google Scholar
Drummond MF. 1988 Economic aspects of cataract. Ophthalmology. 95: 1147– 1153.Google Scholar
Frost A, Hopper C, Frankel S, et al. 2001 The population requirement for cataract extraction: A cross-sectional study. Eye. 15: 745– 752.Google Scholar
Hanning M, Lundström M. 1998 Assessment of the maximum waiting time guarantee for cataract surgery: The case of a Swedish policy. Int J Technol Assess Health Care. 14: 180– 193.Google Scholar
Hawthorne G, Richardson J, Day NA. 2001 A comparison of the assessment of quality of life (AqoL) with four other generic utility instruments. Ann Med. 33: 358– 370.Google Scholar
Hirvelä H, Luukinen H, Laatikainen L. 1995 Prevalence and risk factors of lens opacities in the elderly in Finland. A population based study. Ophthalmology. 102: 108– 117.Google Scholar
Kahn HA, Liebowitz HM, Ganley JP, et al. 1977 The Framingham Eye Study: Outline and major prevalence findings. Am J Epidemiol. 106: 17– 32.Google Scholar
Klein B, Klein R, Linton KL. 1992 Prevalence of age-related lens opacities in a population. The Beaver Dam Eye Study. Ophthalmology. 99: 546– 552.Google Scholar
Klein BEK, Magli YL, Neider MW, Klein R. 1990 Wisconsin system for classification of cataracts from photographs (protocol). Madison, WI: University of Wisconsin-Madison: 1– 28.
Kobelt G, Lundström M, Stenevi U. 2002 Measuring utility and outcome in cataract surgery. J Cataract Refract Surg. 28: 1742– 1749.Google Scholar
Kocur I, Resnikoff S, Foster A. 2002 Eye healthcare services in eastern Europe: I. Cataract surgery. Br J Ophthalmol. 86: 847– 850.Google Scholar
Leske CM, Connell AMS, Wu SY. 1997 et al. Prevalence of lens opacities in the Barbados Eye Study. Arch Ophthalmol. 115: 105– 111.Google Scholar
Lundström M, Roos P, Jensen S, Fregell G. 1997 Catquest questionnaire for use in cataract surgery care: Description, validity and reliability. J Cataract Refract Surg. 23: 1226– 1236.Google Scholar
Lundström M, Stenevi U, Thorburn W, Roos P. 1998 Catquest questionnaire for use in cataract surgery care: Assessment of surgical outcomes. J Cataract Refract Surg. 24: 688– 691.Google Scholar
Lundström M, Stenevi U, Thorburn W. 2001 Quality of life after first- and second-eye cataract surgery. Five-year data collected by the Swedish National Cataract Register. J Cataract Refract Surg. 27: 1553– 1559.Google Scholar
Lundström M, Brege KG, Florén I, Stenevi U, Thorburn W. 2002 Strategy to reduce the number of patients perceiving impaired visual function after cataract surgery. J Cataract Refract Surg. 28: 971– 976.Google Scholar
Lundström M, Stenevi U, Thorburn W. 2002 The Swedish National Cataract Register: A 9-year review. Acta Ophthalmol Scand. 80: 248– 257.Google Scholar
Lundström M, Albrecht S. 2003 Previous cataract surgery in a defined Swedish population. J Cataract Refract Surg. 29: 50– 56.Google Scholar
McCarty CA, Keeffe JE, Taylor HR. 1999 The need for cataract surgery: Projections based on lens opacity, visual acuity, and personal concern. Br J Ophthalmol. 83: 62– 65.Google Scholar
Mitchell P, Cumming RG, Attebo K, et al. 1997 Prevalence of cataract in Australia. The Blue Mountains Eye Study. Ophthalmology. 104: 581– 588.Google Scholar
Nemeth J, Molnar F, Kocur I. 2002 Eye health care in Hungary. Eur J Ophthalmol. 12: 228– 231.Google Scholar
Riley AF, Grupcheva CN, Malik TY, Craig JP, McGhee CN. 2001 The waiting game: Natural history of a cataract waiting list in New Zealand. Clin Exp Ophthalmol. 29: 376– 380.Google Scholar
Stenevi U, Lundström M, Thorburn W. 2000 The cost of having cataract patients waiting for surgery. Acta Ophthalmol Scand. 78: 703– 705.Google Scholar
Taylor HR. 1989 Ultraviolet radiation and the eye: An epidemiologic study. Trans Am Ophthalmol Soc. 87: 802– 851.Google Scholar
Taylor HR. 2000 Cataract: How much surgery do we have to do? Br J Ophthalmol. 84: 1– 2.Google Scholar
Torrance GW. 1986 Measurement of health state utilities for economic appraisal. J Health Econ. 5: 1– 30.Google Scholar
Torrance GW, Zhang Y, Feeny DH, et al. 1992. Multi-attribute value and utility functions for a comprehensive health status classification system. Toronto: McMaster University Research Report
World Health Organisation. 1997. Fact Sheet No 145. Blindness and visual disability. Socioeconomic aspect. Geneva: WHO
World Health Organisation. 2000. Fact Sheet No 214. Control of major blinding diseases and disorders (2). Geneva: WHO