Skip to main content

Economic Evaluation of Keratoplasty

  • Chapter
  • First Online:
Corneal Transplantation

Abstract

The economic evaluation of healthcare interventions is now a prerequisite in many jurisdictions. Adoption of new healthcare interventions cannot only be based on their efficacy and safety. In the context of limited healthcare resources we are facing, their economic impact should also be considered. To estimate the economic impact of health interventions, methods for economic evaluation have been developed and adopted. The main objective of these economic evaluations is to help the healthcare decision makers to select interventions that will support a better allocation of resources.

Alongside the development of different surgical techniques for corneal transplantation, economic evaluations have been performed. The new surgical procedures have improved the clinical performance of corneal transplantation, and in most cases these new interventions were shown to be cost-effective.

Only a few economic evaluations of corneal transplantation techniques have been performed in only a few different countries. Additional economic evaluations are needed to assess the economic impact of these interventions over many more contexts of use.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Drummond MF, O’Brien B, Stoddard GL, Torrance GW. Methods for the economic evaluation of health care programmes. 3rd ed. Oxford: Oxford Medical Publication, Oxford University Press; 2005.

    Google Scholar 

  2. Canadian Agency for Drugs and Technologies in Health. Guidelines for the economic evaluation of health technologies: Canada. 3rd ed. Ottawa: Canadian Agency for Drugs and Technologies in Health; 2006.

    Google Scholar 

  3. Neyt M, Van Brabandt H. The importance of the comparator in economic evaluations: working on the efficiency frontier. Pharmacoeconomics. 2011;29(11):913–6. doi:10.2165/11595260-000000000-00000.

    Article  PubMed  Google Scholar 

  4. World Health Organization. Human organ and tissue transplantation. Report by the Secretariat; 2003.

    Google Scholar 

  5. Canadian Blood Services. Demand for ocular tissue in Canada – final report Ottawa; 2010.

    Google Scholar 

  6. EBAA. 2013 Eye banking statistical report. Washington, DC: EBAA; 2014.

    Google Scholar 

  7. Brown GC. Vision and quality-of-life. Trans Am Ophthalmol Soc. 1999;97:473–511.

    PubMed Central  CAS  PubMed  Google Scholar 

  8. Brown MM, Brown GC, Sharma S, Busbee B. Quality of life associated with visual loss: a time tradeoff utility analysis comparison with medical health states. Ophthalmology. 2003;110(6):1076–81. doi:10.1016/S0161-6420(03)00254-9.

    Article  PubMed  Google Scholar 

  9. Brown MM, Brown GC, Sharma S, Busbee B, Brown H. Quality of life associated with unilateral and bilateral good vision. Ophthalmology. 2001;108(4):643–7; discussion 7–8.

    Article  CAS  PubMed  Google Scholar 

  10. Tillett CW. Posterior lamellar keratoplasty. Am J Ophthalmol. 1956;41(3):530–3.

    Article  CAS  PubMed  Google Scholar 

  11. Melles GR, Eggink FA, Lander F, Pels E, Rietveld FJ, Beekhuis WH, et al. A surgical technique for posterior lamellar keratoplasty. Cornea. 1998;17(6):618–26.

    Article  CAS  PubMed  Google Scholar 

  12. Melles GR, Lander F, Beekhuis WH, Remeijer L, Binder PS. Posterior lamellar keratoplasty for a case of pseudophakic bullous keratopathy. Am J Ophthalmol. 1999;127(3):340–1.

    Article  CAS  PubMed  Google Scholar 

  13. Melles GR, Lander F, Nieuwendaal C. Sutureless, posterior lamellar keratoplasty: a case report of a modified technique. Cornea. 2002;21(3):325–7.

    Article  PubMed  Google Scholar 

  14. Melles GR, Lander F, van Dooren BT, Pels E, Beekhuis WH. Preliminary clinical results of posterior lamellar keratoplasty through a sclerocorneal pocket incision. Ophthalmology. 2000;107(10):1850–6; discussion 7.

    Article  CAS  PubMed  Google Scholar 

  15. van Dijk K, Dapena I, Moutsouris K, Ham L, Nieuwendaal C, Melles GR. First DLEK series: 10-year follow-up. Ophthalmology. 2011;118(2):424e1–3. doi:10.1016/j.ophtha.2010.10.006.

    Google Scholar 

  16. van Dooren B, Mulder PG, Nieuwendaal CP, Beekhuis WH, Melles GR. Endothelial cell density after posterior lamellar keratoplasty (Melles techniques): 3 years follow-up. Am J Ophthalmol. 2004;138(2):211–7. doi:10.1016/j.ajo.2004.02.016.

    Article  PubMed  Google Scholar 

  17. van Dooren BT, Mulder PG, Nieuwendaal CP, Beekhuis WH, Melles GR. Endothelial cell density after posterior lamellar keratoplasty: five- to seven-year follow-up. Am J Ophthalmol. 2007;144(3):471–3. doi:10.1016/j.ajo.2007.05.015.

    Article  PubMed  Google Scholar 

  18. Terry MA, Ousley PJ. Deep lamellar endothelial keratoplasty in the first United States patients: early clinical results. Cornea. 2001;20(3):239–43.

    Article  CAS  PubMed  Google Scholar 

  19. Terry MA, Ousley PJ. Replacing the endothelium without corneal surface incisions or sutures: the first United States clinical series using the deep lamellar endothelial keratoplasty procedure. Ophthalmology. 2003;110(4):755–64. doi:10.1016/s0161-6420(02)01939-5; discussion 64.

    Article  PubMed  Google Scholar 

  20. Ousley PJ, Terry MA. Stability of vision, topography, and endothelial cell density from 1 year to 2 years after deep lamellar endothelial keratoplasty surgery. Ophthalmology. 2005;112(1):50–7. doi:10.1016/j.ophtha.2004.07.028.

    Article  PubMed  Google Scholar 

  21. Terry MA. Endothelial keratoplasty: clinical outcomes in the two years following deep lamellar endothelial keratoplasty (an American Ophthalmological Society thesis). Trans Am Ophthalmol Soc. 2007;105:530–63.

    PubMed Central  PubMed  Google Scholar 

  22. Terry MA, Ousley PJ. Rapid visual rehabilitation after endothelial transplants with deep lamellar endothelial keratoplasty (DLEK). Cornea. 2004;23(2):143–53.

    Article  PubMed  Google Scholar 

  23. Terry MA, Wall JM, Hoar KL, Ousley PJ. A prospective study of endothelial cell loss during the 2 years after deep lamellar endothelial keratoplasty. Ophthalmology. 2007;114(4):631–9. doi:10.1016/j.ophtha.2006.11.024.

    Article  PubMed  Google Scholar 

  24. Melles GR, Wijdh RH, Nieuwendaal CP. A technique to excise the Descemet membrane from a recipient cornea (descemetorhexis). Cornea. 2004;23(3):286–8.

    Article  PubMed  Google Scholar 

  25. Price Jr FW, Price MO. Descemet’s stripping with endothelial keratoplasty in 200 eyes: early challenges and techniques to enhance donor adherence. J Cataract Refract Surg. 2006;32(3):411–8. doi:10.1016/j.jcrs.2005.12.078.

    Article  PubMed  Google Scholar 

  26. Gorovoy MS. Descemet-stripping automated endothelial keratoplasty. Cornea. 2006;25(8):886–9. doi:10.1097/01.ico.0000214224.90743.01.

    Article  PubMed  Google Scholar 

  27. Terry MA, Shamie N, Chen ES, Phillips PM, Hoar KL, Friend DJ. Precut tissue for Descemet’s stripping automated endothelial keratoplasty: vision, astigmatism, and endothelial survival. Ophthalmology. 2009;116(2):248–56. doi:10.1016/j.ophtha.2008.09.017.

    Article  PubMed  Google Scholar 

  28. Melles GR, Lander F, Rietveld FJ. Transplantation of Descemet’s membrane carrying viable endothelium through a small scleral incision. Cornea. 2002;21(4):415–8.

    Article  PubMed  Google Scholar 

  29. Gorovoy MS. DMEK complications. Cornea. 2014;33(1):101–4. doi:10.1097/ico.0000000000000023.

    Article  PubMed  Google Scholar 

  30. Guerra FP, Anshu A, Price MO, Giebel AW, Price FW. Descemet’s membrane endothelial keratoplasty: prospective study of 1-year visual outcomes, graft survival, and endothelial cell loss. Ophthalmology. 2011;118(12):2368–73. doi:10.1016/j.ophtha.2011.06.002.

    Article  PubMed  Google Scholar 

  31. Monnereau C, Quilendrino R, Dapena I, Liarakos VS, Alfonso JF, Arnalich-Montiel F, et al. Multicenter study of descemet membrane endothelial keratoplasty: first case series of 18 surgeons. JAMA Ophthalmol. 2014. doi:10.1001/jamaophthalmol.2014.1710.

    PubMed  Google Scholar 

  32. Terry MA. Endothelial keratoplasty: why aren’t we all doing Descemet membrane endothelial keratoplasty? Cornea. 2012;31(5):469–71. doi:10.1097/ICO.0b013e31823f8ee2.

    Article  PubMed  Google Scholar 

  33. Bahar I, Kaiserman I, McAllum P, Slomovic A, Rootman D. Comparison of posterior lamellar keratoplasty techniques to penetrating keratoplasty. Ophthalmology. 2008;115(9):1525–33. doi:10.1016/j.ophtha.2008.02.010.

    Article  PubMed  Google Scholar 

  34. Heidemann DG, Dunn SP, Chow CY. Comparison of deep lamellar endothelial keratoplasty and penetrating keratoplasty in patients with Fuchs endothelial dystrophy. Cornea. 2008;27(2):161–7. doi:10.1097/ICO.0b013e31815b8304.

    Article  PubMed  Google Scholar 

  35. Pedersen IB, Ivarsen A, Hjortdal J. Graft rejection and failure following endothelial keratoplasty (DSAEK) and penetrating keratoplasty for secondary endothelial failure. Acta Ophthalmol. 2014. doi:10.1111/aos.12518.

    PubMed  Google Scholar 

  36. Price MO, Gorovoy M, Price Jr FW, Benetz BA, Menegay HJ, Lass JH. Descemet’s stripping automated endothelial keratoplasty: three-year graft and endothelial cell survival compared with penetrating keratoplasty. Ophthalmology. 2013;120(2):246–51. doi:10.1016/j.ophtha.2012.08.007.

    Article  PubMed Central  PubMed  Google Scholar 

  37. Hjortdal J, Pedersen IB, Bak-Nielsen S, Ivarsen A. Graft rejection and graft failure after penetrating keratoplasty or posterior lamellar keratoplasty for fuchs endothelial dystrophy. Cornea. 2013;32(5):e60–3. doi:10.1097/ICO.0b013e3182687ff3.

    Article  PubMed  Google Scholar 

  38. Ezon I, Shih CY, Rosen LM, Suthar T, Udell IJ. Immunologic graft rejection in descemet’s stripping endothelial keratoplasty and penetrating keratoplasty for endothelial disease. Ophthalmology. 2013;120(7):1360–5. doi:10.1016/j.ophtha.2012.12.036.

    Article  PubMed  Google Scholar 

  39. Anshu A, Price MO, Price Jr FW. Risk of corneal transplant rejection significantly reduced with Descemet’s membrane endothelial keratoplasty. Ophthalmology. 2012;119(3):536–40. doi:10.1016/j.ophtha.2011.09.019.

    Article  PubMed  Google Scholar 

  40. Phillips PM, Terry MA, Shamie N, Chen ES, Hoar KL, Stoeger C, et al. Descemet’s stripping automated endothelial keratoplasty (DSAEK) using corneal donor tissue not acceptable for use in penetrating keratoplasty as a result of anterior stromal scars, pterygia, and previous corneal refractive surgical procedures. Cornea. 2009;28(8):871–6. doi:10.1097/ICO.0b013e318199f8d7.

    Article  PubMed  Google Scholar 

  41. Groeneveld-van Beek EA, Lie JT, van der Wees J, Bruinsma M, Melles GR. Standardized ‘no-touch’ donor tissue preparation for DALK and DMEK: harvesting undamaged anterior and posterior transplants from the same donor cornea. Acta Ophthalmol. 2013;91(2):145–50. doi:10.1111/j.1755-3768.2012.02462.x.

    Article  CAS  PubMed  Google Scholar 

  42. Heindl LM, Riss S, Bachmann BO, Laaser K, Kruse FE, Cursiefen C. Split cornea transplantation for 2 recipients: a new strategy to reduce corneal tissue cost and shortage. Ophthalmology. 2011;118(2):294–301. doi:10.1016/j.ophtha.2010.05.025.

    Article  PubMed  Google Scholar 

  43. Borderie VM, Boelle PY, Touzeau O, Allouch C, Boutboul S, Laroche L. Predicted long-term outcome of corneal transplantation. Ophthalmology. 2009;116(12):2354–60. doi:10.1016/j.ophtha.2009.05.009.

    Article  PubMed  Google Scholar 

  44. Borderie VM, Sandali O, Bullet J, Gaujoux T, Touzeau O, Laroche L. Long-term results of deep anterior lamellar versus penetrating keratoplasty. Ophthalmology. 2012;119(2):249–55. doi:10.1016/j.ophtha.2011.07.057.

    Article  PubMed  Google Scholar 

  45. Borderie VM, Guilbert E, Touzeau O, Laroche L. Graft rejection and graft failure after anterior lamellar versus penetrating keratoplasty. Am J Ophthalmol. 2011;151(6):1024–9e1. doi:10.1016/j.ajo.2011.01.007.

    Article  PubMed  Google Scholar 

  46. Reinhart WJ, Musch DC, Jacobs DS, Lee WB, Kaufman SC, Shtein RM. Deep anterior lamellar keratoplasty as an alternative to penetrating keratoplasty a report by the american academy of ophthalmology. Ophthalmology. 2011;118(1):209–18. doi:10.1016/j.ophtha.2010.11.002.

    Article  PubMed  Google Scholar 

  47. Cheng YY, Visser N, Schouten JS, Wijdh RJ, Pels E, van Cleynenbreugel H, et al. Endothelial cell loss and visual outcome of deep anterior lamellar keratoplasty versus penetrating keratoplasty: a randomized multicenter clinical trial. Ophthalmology. 2011;118(2):302–9. doi:10.1016/j.ophtha.2010.06.005.

    Article  PubMed  Google Scholar 

  48. Hirneiss C, Neubauer AS, Niedermeier A, Messmer EM, Ulbig M, Kampik A. Cost utility for penetrating keratoplasty in patients with poor binocular vision. Ophthalmology. 2006;113(12):2176–80. doi:10.1016/j.ophtha.2006.05.060.

    Article  CAS  PubMed  Google Scholar 

  49. Bose S, Ang M, Mehta JS, Tan DT, Finkelstein E. Cost-effectiveness of Descemet’s stripping endothelial keratoplasty versus penetrating keratoplasty. Ophthalmology. 2013;120(3):464–70. doi:10.1016/j.ophtha.2012.08.024.

    Article  PubMed  Google Scholar 

  50. Prabhu SS, Kaakeh R, Sugar A, Smith DG, Shtein RM. Comparative cost-effectiveness analysis of Descemet stripping automated endothelial keratoplasty versus penetrating keratoplasty in the United States. Am J Ophthalmol. 2013;155(1):45–53e1. doi:10.1016/j.ajo.2012.06.014.

    Article  PubMed Central  PubMed  Google Scholar 

  51. van den Biggelaar FJ, Cheng YY, Nuijts RM, Schouten JS, Wijdh RJ, Pels E, et al. Economic evaluation of endothelial keratoplasty techniques and penetrating keratoplasty in the Netherlands. Am J Ophthalmol. 2012;154(2):272–81e2. doi:10.1016/j.ajo.2012.02.023.

    Article  PubMed  Google Scholar 

  52. van den Biggelaar FJ, Cheng YY, Nuijts RM, Schouten JS, Wijdh RJ, Pels E, et al. Economic evaluation of deep anterior lamellar keratoplasty versus penetrating keratoplasty in The Netherlands. Am J Ophthalmol. 2011;151(3):449–59e2. doi:10.1016/j.ajo.2010.09.012.

    Article  PubMed  Google Scholar 

  53. Koo TS, Finkelstein E, Tan D, Mehta JS. Incremental cost-utility analysis of deep anterior lamellar keratoplasty compared with penetrating keratoplasty for the treatment of keratoconus. Am J Ophthalmol. 2011;152(1):40–7e2. doi:10.1016/j.ajo.2011.01.017.

    Article  PubMed  Google Scholar 

  54. Beauchemin C, Brunette I, Boisjoly H, Freeman EE, Popescu M, Lachaine J. Economic impact of the advent of posterior lamellar keratoplasty in Montreal, Quebec. Can J Ophthalmol. 2010;45(3):243–51. doi:10.3129/i10-026.

    Article  PubMed  Google Scholar 

  55. Roe RH, Lass JH, Brown GC, Brown MM. The value-based medicine comparative effectiveness and cost-effectiveness of penetrating keratoplasty for keratoconus. Cornea. 2008;27(9):1001–7. doi:10.1097/ICO.0b013e31817bb062.

    Article  PubMed  Google Scholar 

  56. Tan TE, Peh GS, George BL, Cajucom-Uy HY, Dong D, Finkelstein EA, et al. A cost-minimization analysis of tissue-engineered constructs for corneal endothelial transplantation. PLoS One. 2014;9(6):e100563. doi:10.1371/journal.pone.0100563.

    Article  PubMed Central  PubMed  Google Scholar 

  57. Brown MM, Brown GC, Sharma S, Garrett S. Evidence-based medicine, utilities, and quality of life. Curr Opin Ophthalmol. 1999;10(3):221–6.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jean Lachaine PhD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Brunette, I., Beauchemin, C., Lachaine, J. (2016). Economic Evaluation of Keratoplasty. In: Hjortdal, J. (eds) Corneal Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-24052-7_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-24052-7_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-24050-3

  • Online ISBN: 978-3-319-24052-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics