Topical versus peribulbar anesthesia in non-penetrating deep sclerectomy. A cost-effectiveness analysis

Abstract

To assess the costs and cost-effectiveness ratio of topical and peribulbar anesthesia in non-penetrating deep sclerectomy for the surgical treatment of open-angle glaucoma. We evaluated the associated direct costs with both topical and peribulbar anesthesia. Effectiveness was defined as the proportion of patients that experienced no pain during the surgical procedure and was obtained from the literature. Cost-effectiveness was defined as direct cost of anesthesia per patient with no pain. We also calculated the incremental cost-effectiveness ratio (ICER) in order to determine which intervention was dominant. Direct costs were US$ 45.60 and US$ 49.18 for topical and peribulbar anesthesia respectively. The great majority of patients experienced no pain with any of the procedures (91.7% for the topical group and 69.7% for the peribulbar group). Cost-effectiveness ratio was US$ 49.73 for topical anesthesia and US$ 70.56 for peribulbar anesthesia. The ICER was negative and topical anesthesia was dominant over peribulbar anesthesia. Topical anesthesia was less costly and more effective than peribulbar anesthesia in avoiding pain in non-penetrating deep sclerectomy.