Related Experiment Video
Updated: Aug 4, 2025
07:30
Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
11.1K
Cost-effectiveness analysis of endoscopic dacryocystorhinostomy using Markov modelling
Jenny Q Hu1, Clara J Men2, Natalie A Afshari1
1Shiley Eye Institute, University of California San Diego, La Jolla, CA.
Summary
Endoscopic dacryocystorhinostomy (DCR) is a cost-effective treatment for nasolacrimal duct obstruction, offering significant value per quality-adjusted life-year. This surgical approach proves more economical than no surgery in most analyses.
Area of Science:
- Ophthalmology
- Health Economics
- Surgical Outcomes
Background:
- Nasolacrimal duct obstruction (NLDO) can significantly impact quality of life.
- Epiphora, a symptom of NLDO, negatively affects patient well-being.
- Surgical interventions aim to restore tear drainage and alleviate symptoms.
Purpose of the Study:
- To evaluate the cost-effectiveness of endoscopic dacryocystorhinostomy (DCR) compared to non-surgical management for NLDO.
- To quantify the economic value of endoscopic DCR in improving patient health outcomes.
Main Methods:
- A Markov model was developed to simulate patient pathways.
- The model compared outcomes and costs of endoscopic DCR versus no surgery.
- Sensitivity analyses, including probabilistic methods, assessed model robustness.
Main Results:
- Endoscopic DCR demonstrated cost-effectiveness with an ICER of $2162 per QALY.
- The model's sensitivity was highest concerning the quality-of-life impact of epiphora.
- Probabilistic analysis indicated endoscopic DCR is cost-effective in 93.7% of simulations.
Conclusions:
- Endoscopic DCR is an economically viable treatment for epiphora caused by NLDO.
- The quality of life reduction due to epiphora is a critical factor in cost-effectiveness.
- Advancements in surgical techniques enhance the efficacy and cost-effectiveness of endoscopic DCR.
