Cost analysis of childhood glaucoma surgeries using the US Medicaire allowable costs

To analyze and calculate the relative cost of various childhood glaucoma surgical interventions per mm Hg intraocular pressure (IOP) reduction (＄/mm Hg).

Representative index studies were reviewed to quantitate the reduction of mean IOP and glaucoma medications for each surgical intervention in childhood glaucoma. A US perspective was adopted, using Medicare allowable costs to calculate cost/mm Hg IOP reduction (＄/mm Hg) at 1y postoperatively.

At 1y postoperatively, the cost/mm Hg IOP reduction was ＄226/mm Hg for microcatheter-assisted circumferential trabeculotomy, ＄284/mm Hg for cyclophotocoagulation, ＄288/mm Hg for conventional ab-externo trabeculotomy, ＄338/mm Hg for Ahmed glaucoma valve, ＄350/mm Hg for Baerveldt glaucoma implant, ＄351/mm Hg for goniotomy, and ＄400/mm Hg for trabeculectomy.

Microcatheter-assisted circumferential trabeculotomy is the most cost-efficient surgical method to lower IOP in childhood glaucoma, while trabeculectomy is the least cost-efficient surgical method.