Cost analysis of the Lucia keratoprosthesis in a resource-limited tertiary care center

To analyze the associated costs of the implantation of the Lucia Keratoprosthesis (KPro) in a resource-limited tertiary care center.

A retrospective chart review was conducted on patients who underwent Lucia KPro implantation. For the first 24 months of follow-up, the costs for initial evaluation, surgery, postoperative visits, and management of complications were assessed and converted to U.S. dollars. Visual outcomes were analyzed based on best-corrected visual acuity (BCVA) improvement and anatomical retention.

A total of 24 eyes from 24 patients were analyzed. The mean follow-up was 34 months, with a mean total cost per patient of $6,949.55 ± $1,344.54. The initial surgical cost was $2,582.31 ± 980.13. At the same time, postoperative expenses constituted 62.84% of the total fees, largely driven by the medical costs and surgical management of complications such as glaucoma (37.5%), retroprosthetic membranes (33.3%), and epithelial defects (16.7%). The mean BCVA improved from 2.40 ± 0.28 LogMAR preoperatively to 1.32 ± 1.03 LogMAR at the final follow-up (Δ = 1.08 LogMAR, p < 0.001). Anatomic retention was 95.83%, and functional success (BCVA ≥ 20/200) was achieved in 62.50% of cases.

The Lucia KPro offers a cost-friendly alternative to address corneal blindness in resource-limited settings. Postoperative care remains a major cost driver. Strategies to prevent complications, telemedicine-based follow-ups, and national subsidy programs could further optimize accessibility and cost-effectiveness. Future multicenter studies should explore cost-sharing models to improve financial feasibility.