Outcome of Different Surgical Repair Techniques for Rhegmatogenous Retinal Detachment—A Health Economic Analysis in the Split-Dalmatia County, Croatia
<b>Purpose:</b> The goal of this research is to investigate the characteristics and surgical techniques for repairing rhegmatogenous retinal detachment (RRD) and their influence on anatomical and functional success of the treatment with a special emphasis on the economic costs and outcom...
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MDPI AG
2024-03-01
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| Online Access: | https://www.mdpi.com/2227-9032/12/6/648 |
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| author | Ivan Borjan Ivna Pleština-Borjan Silvia N. W. Hertzberg Alen Siničić Ljubo Znaor Beáta Éva Petrovski Goran Petrovski |
| author_facet | Ivan Borjan Ivna Pleština-Borjan Silvia N. W. Hertzberg Alen Siničić Ljubo Znaor Beáta Éva Petrovski Goran Petrovski |
| author_sort | Ivan Borjan |
| collection | DOAJ |
| description | <b>Purpose:</b> The goal of this research is to investigate the characteristics and surgical techniques for repairing rhegmatogenous retinal detachment (RRD) and their influence on anatomical and functional success of the treatment with a special emphasis on the economic costs and outcome quality-adjusted life years (QALYs) of the procedures. <b>Methods:</b> This retrospective study analyzed data from 151 patients with RRD treated at the Department of Ophthalmology, Clinical Hospital Centre Split, Croatia, in a 3-year period, using one of three surgical techniques: pneumoretinopexy (PR), scleral buckling (SB) or pars plana vitrectomy (PPV), followed-up for at least 6 months. Demographic, pre- and post-operative ophthalmic exam parameters and surgical technique used were collected accordingly. Statistical analysis of the influence of the studied parameters upon anatomical and functional outcomes was performed, as well as health economic analysis on costs and derived utilities/QALYs of these surgical methods. <b>Results:</b> Of all patients, 130 (86%) were successfully operated on, and 21 patients (14%) required another surgical procedure. No statistically significant differences in the anatomical success between the 3 surgical techniques were found. However, the functional outcome (based on the final best corrected visual acuity (BCVA)) differed significantly. Despite improvement in the final BCVA, BCVA ≥ 0.5 was achieved in only 52 (34.4%) patients. The final BCVA showed significant association with the time elapsed from the onset of RRD to the surgical intervention, pre-operative BCVA, macular- and preoperative lens- status and type of surgery. The estimated diagnosis-related group (DRG) cost for day and inpatient surgery was based upon existing DRG cost for PPV, which for PR and SB was calculated accordingly. Based upon the success of the procedure and visual outcome, the overall calculated QALYs for PR and SB appeared to be similar, while the QALYs were lower for PPV. <b>Conclusions:</b> The success rate of treating RRD mostly depends on performing an early surgical procedure (especially in the case of attached macula), identification of all retina tears and, most importantly, choosing the appropriate surgical technique. Decisions on treatment for RRD should also be based upon cost-effective and QALYs-assessed procedures, especially in countries like Croatia, where limited healthcare resources exist. This study shows PR to be efficient and most cost-effective for RRD repairment in appropriate cases. |
| first_indexed | 2024-04-24T18:13:53Z |
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| spelling | doaj.art-c2cc577e794741a6b700f586ed1963012024-03-27T13:43:42ZengMDPI AGHealthcare2227-90322024-03-0112664810.3390/healthcare12060648Outcome of Different Surgical Repair Techniques for Rhegmatogenous Retinal Detachment—A Health Economic Analysis in the Split-Dalmatia County, CroatiaIvan Borjan0Ivna Pleština-Borjan1Silvia N. W. Hertzberg2Alen Siničić3Ljubo Znaor4Beáta Éva Petrovski5Goran Petrovski6Department of Ophthalmology, University Hospital Center Split, 21000 Split, CroatiaSchool of Medicine, University of Split, Šoltanska 2, 21000 Split, CroatiaCenter for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, 0450 Oslo, NorwayDepartment of Ophthalmology, University Hospital Center Split, 21000 Split, CroatiaDepartment of Ophthalmology, University Hospital Center Split, 21000 Split, CroatiaCenter for Eye Research and Innovative Diagnostics, Department of Ophthalmology, Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, 0450 Oslo, NorwaySchool of Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia<b>Purpose:</b> The goal of this research is to investigate the characteristics and surgical techniques for repairing rhegmatogenous retinal detachment (RRD) and their influence on anatomical and functional success of the treatment with a special emphasis on the economic costs and outcome quality-adjusted life years (QALYs) of the procedures. <b>Methods:</b> This retrospective study analyzed data from 151 patients with RRD treated at the Department of Ophthalmology, Clinical Hospital Centre Split, Croatia, in a 3-year period, using one of three surgical techniques: pneumoretinopexy (PR), scleral buckling (SB) or pars plana vitrectomy (PPV), followed-up for at least 6 months. Demographic, pre- and post-operative ophthalmic exam parameters and surgical technique used were collected accordingly. Statistical analysis of the influence of the studied parameters upon anatomical and functional outcomes was performed, as well as health economic analysis on costs and derived utilities/QALYs of these surgical methods. <b>Results:</b> Of all patients, 130 (86%) were successfully operated on, and 21 patients (14%) required another surgical procedure. No statistically significant differences in the anatomical success between the 3 surgical techniques were found. However, the functional outcome (based on the final best corrected visual acuity (BCVA)) differed significantly. Despite improvement in the final BCVA, BCVA ≥ 0.5 was achieved in only 52 (34.4%) patients. The final BCVA showed significant association with the time elapsed from the onset of RRD to the surgical intervention, pre-operative BCVA, macular- and preoperative lens- status and type of surgery. The estimated diagnosis-related group (DRG) cost for day and inpatient surgery was based upon existing DRG cost for PPV, which for PR and SB was calculated accordingly. Based upon the success of the procedure and visual outcome, the overall calculated QALYs for PR and SB appeared to be similar, while the QALYs were lower for PPV. <b>Conclusions:</b> The success rate of treating RRD mostly depends on performing an early surgical procedure (especially in the case of attached macula), identification of all retina tears and, most importantly, choosing the appropriate surgical technique. Decisions on treatment for RRD should also be based upon cost-effective and QALYs-assessed procedures, especially in countries like Croatia, where limited healthcare resources exist. This study shows PR to be efficient and most cost-effective for RRD repairment in appropriate cases.https://www.mdpi.com/2227-9032/12/6/648retinal detachmentscleral bucklingpars plana vitrectomypneumoretinopexyincidencehealth economy |
| spellingShingle | Ivan Borjan Ivna Pleština-Borjan Silvia N. W. Hertzberg Alen Siničić Ljubo Znaor Beáta Éva Petrovski Goran Petrovski Outcome of Different Surgical Repair Techniques for Rhegmatogenous Retinal Detachment—A Health Economic Analysis in the Split-Dalmatia County, Croatia Healthcare retinal detachment scleral buckling pars plana vitrectomy pneumoretinopexy incidence health economy |
| title | Outcome of Different Surgical Repair Techniques for Rhegmatogenous Retinal Detachment—A Health Economic Analysis in the Split-Dalmatia County, Croatia |
| title_full | Outcome of Different Surgical Repair Techniques for Rhegmatogenous Retinal Detachment—A Health Economic Analysis in the Split-Dalmatia County, Croatia |
| title_fullStr | Outcome of Different Surgical Repair Techniques for Rhegmatogenous Retinal Detachment—A Health Economic Analysis in the Split-Dalmatia County, Croatia |
| title_full_unstemmed | Outcome of Different Surgical Repair Techniques for Rhegmatogenous Retinal Detachment—A Health Economic Analysis in the Split-Dalmatia County, Croatia |
| title_short | Outcome of Different Surgical Repair Techniques for Rhegmatogenous Retinal Detachment—A Health Economic Analysis in the Split-Dalmatia County, Croatia |
| title_sort | outcome of different surgical repair techniques for rhegmatogenous retinal detachment a health economic analysis in the split dalmatia county croatia |
| topic | retinal detachment scleral buckling pars plana vitrectomy pneumoretinopexy incidence health economy |
| url | https://www.mdpi.com/2227-9032/12/6/648 |
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