Cost analysis of surgical intraocular pressure management in glaucoma

Abdelrahman M. Elhusseiny, Nicolas A. Yannuzzi, Mohamed M. Khodeiry, Richard K. Lee, William E. Smiddy

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Purpose: To quantify and to analyze the relative cost of various glaucoma surgical procedures and selective laser trabeculoplasty surgery per mm Hg intraocular pressure (IOP) reduction ($/mmHg) since standard cost-utility methods are not well suited to the study of glaucoma which characteristically only claims visual acuity in its end stages. Methods: Published glaucoma treatment studies were reviewed to quantitate the reduction of mean IOP and glaucoma medications for a given treatment modality. A United States perspective was adopted, using Medicare allowable costs were used to calculate a newly introduced parameter - cost per mmHg IOP reduction- at 1 year postoperatively. Results: The cost per mmHg IOP reduction after one year of treatment ranged from $190/mmHg for trabeculectomy to $1376/mmHg for iStent. For reference, the cost of selective later trabeculoplasty surgery was $121/mmHg. After the first year, cost/mmHg ranged from $12/mmHg to $61/mmHg. Conclusions: Conventional glaucoma surgeries and SLT surgery were the most cost-efficient surgical methods to lower intraocular pressure compared to the various MIGS options. They may be more appropriate management when cost is an important issue.

Original languageEnglish (US)
JournalJournal of glaucoma
StateAccepted/In press - 2021


  • Cost analysis
  • Glaucoma
  • Intraocular pressure
  • MIGS

ASJC Scopus subject areas

  • Ophthalmology


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