Cost Minimization Analysis of Precut Cornea Grafts in Descemet Stripping Automated Endothelial Keratoplasty.

摘要: Descemet stripping automated endothelial keratoplasty (DSAEK) is the most common corneal transplant procedure. A key step in procedure preparing donor cornea for transplantation. This can be accomplished via 1 of 3 alternatives: surgeon cuts on day surgery, precut ahead time an offsite facility by a trained technician, or purchased from eye bank. Currently, there little evidence costs and effectiveness these strategies to allow healthcare providers decide upon preferred method prepare grafts. The aim this study was compare relative each strategy. The Singapore National Eye Centre Bank performed both surgeon-cut services between 2009 2013. This included 110 subjects who received 140 cornea. Clinical outcomes surgical duration were compared across using propensity score matching. The cost strategy estimated microcosting consisted procedural including duration. One-way sensitivity analysis threshold performed. The DSAEK highest approach ($13,965 per procedure), followed purchasing corneas ($12,659) then setting up precutting ($12,421). higher largely due longer (surgeon-cut = 72.54 minutes, precut = 59.45 minutes, P < 0.001) fees. There no differences clinical grafts that surgeon-cut. Threshold demonstrated if number cases below 31 year, yielded lowest If more than 290 annually, cheapest option would setup facility. Our findings suggest it efficient centers are performing large transplants (more cases) set their own conduct precutting.