DSAEK may be more cost-effective than PK

The authors retrospectively compared the cost-effectiveness of Descemet stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PK) for corneal endothelial disease from a third-party payer perspective with a five-year time horizon. The results indicate that favorable cost and utility outcomes were associated with DSAEK for the treatment of corneal endothelial disease.

They reviewed published literature to calculate the outcome and complication probabilities of each procedure, and constructed a model to compare the costs and utilities.

They found DSAEK to be less costly compared with PK ($9,362 vs. $10,239), with greater utility (3.15 vs. 2.47 quality-adjusted life years). Sensitivity analyses revealed that even at graft failure rates approaching those of PK, DSAEK would still reduce costs.

The authors say that given the improved speed of recovery and fewer postoperative visits associated with uncomplicated DSAEK, the third-party payer perspective likely provides a conservative estimate of the cost savings associated with DSAEK compared with PK.

They add that longer follow-up of DSAEK outcomes will provide more accurate information regarding the long-term cost-effectiveness of the procedure.