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.