Modeling utility of second-eye cataract surgery

Area of Science:

• Ophthalmology
• Public Health
• Health Economics

Background:

• Cataract surgery is a common procedure impacting visual function and quality of life.
• The optimal allocation of resources between first-eye and second-eye surgeries remains a key consideration for public health.

Purpose of the Study:

• To evaluate the public health impact of varying proportions of first-eye and second-eye cataract surgeries.
• To determine the optimal strategy for resource allocation in cataract surgery based on population utility.

Main Methods:

• A population model was developed for the County of Blekinge, simulating a fixed cataract surgical rate.
• Data on cataract prevalence, surgical need, utility values, and mortality were sourced from literature and national databases.
• The model analyzed varying proportions of first-eye and second-eye surgeries and their impact on population utility and disability.

Main Results:

• A higher proportion of second-eye surgeries (42%) yielded a mean utility of 0.82239 in those aged 40+, compared to 0.82253 with lower second-eye surgery rates (25%).
• High second-eye surgery rates resulted in 421 more individuals considered 'well' but also 152 more with disability and 118 more with dependence.
• Conversely, lower second-eye surgery rates led to fewer individuals with disability and dependence.

Conclusions:

• Prioritizing first-eye surgeries maximizes population utility when the cataract surgical rate is insufficient.
• When the cataract surgical rate is high, increasing second-eye surgeries optimizes quality of life for a larger population segment.