Why Do Phacoemulsification? Manual Small-Incision Cataract Surgery Is Almost as Effective, but Less Expensive
Received 2 October 2005; accepted 30 August 2006. published online 12 February 2007.
Purpose
To compare the cost of phacoemulsification with foldable lenses with that of manual small-incision cataract surgery (SICS) in a hospital setting.
Design
Average cost comparision between 2 surgical techniques.
Participants
Four hundred patients and 4 surgeons.
Methods
A single masked randomized controlled clinical trial was conducted previously to compare safety and efficacy of the 2 techniques for rehabilitation of the cataract patient. The fixed-facility and recurrent (consumables) cost for phacoemulsification and SICS were calculated based on information collected at different sources using standard norms. Average cost per procedure was calculated by dividing the total cost by the number of procedures performed.
Main Outcome Measures
Average fixed-facility cost and average consumable cost for both the techniques.
Results
The average cost of a phacoemulsification surgery for the hospital was Indian rupees (Rs) 1978.89 ($42.10), and the average cost for a SICS surgery was Rs 720.99 ($15.34), of which Rs 500.99 ($10.65) was the fixed-facility cost common to both. Phacoemulsification cost was more because of the foldable lens used.
Conclusions
Phacoemulsification needs additional cost for the machine (depreciation), replenishment of parts, and annual maintenance contract. Manual SICS is far more economical than phacoemulsification. Its visual result is comparable with that of phacoemulsification and is as safe.
2International Centre for Advancement of Rural Eyecare, L. V. Prasad Eye Institute, Hyderabad, India.
Correspondence to Parikshit Gogate, MS, FRCS(Edin), H. V. Desai Eye Hospital, 93, Taravade Vasti, Mohammadwadi, Hadapsar, Pune–411028, Maharashtra, India.
Manuscript no. 2005-932.
Supported by H. V. Desai Eye Hospital.
The authors have no conflicts of interest related to the article.
ABSTRACT