We know that cataract is a vision impairment that requires surgery for its treatment. It is known as the second most common cause of visual impairment in the world and causes blindness. This shows that cataract is still a priority problem for eye diseases which must be addressed.
Cataract surgery can be performed using several surgical techniques, Intra Capsular Cataract Extraction (ICCE), Extra Capsular Cataract Extraction (ECCE), SICS (Small Incision Cataract Surgery ), and Phacoemulsification. But generally cataract surgery in Indonesia uses SICS and phacoemulsification method because the ICCE and ECCE surgical techniques produce large incisions, so patients need a longer rehabilitation period until the incision from the surgery heals completely. Meanwhile, SICS and phacoemulsification techniques are the latest techniques that only require small incisions with relatively short healing process.
Cataract surgery is not cheap, causing many patients to delay their surgery, even though delaying cataract surgery can gradually cause blindness. Therefore, it is necessary to compare the cost of cataract surgery using SICS and phacoemulsification surgery techniques to find out which surgical technique is more cost-effective. This calculation can be done using a cost-effective analysis (CEA) calculation with the Quality-Adjusted Life Years (QALY) method or calculations to improve the quality and quantity of patient life with intervention from health care providers.
The way to find out which technique is more cost-effective is by comparing the costs incurred by patients who undergo surgery using SICS and phacoemulsification techniques, and these observations are made before surgery, during surgery and after the surgery. Furthermore, the calculation of the mean of the two surgical techniques is also required and the results showed that the cataract surgery technique using SICS is less expensive than using phacoemulsification technique. However, there are additional costs before and after operation, so these additional costs also need to be calculated in order to obtain a more cost-effective comparison of operating techniques.
Comparing the advantages of each cataract surgery technique, the phacoemulsification technique uses more sophisticated equipment and results in smaller incision than SICS technique. Meanwhile, the advantage of using SICS technique is that it uses equipment that is easier to operate by novice operators and costs less than using the phacoemulsification technique. However, the main comparison of the two techniques is the post-surgery incision wound healing time because it is related to the number of days of productivity lost due to illness, as well as the need for additional costs for assistants because they have to be hospitalized.
Based on the calculations and observations made, the phacoemulsification surgical technique produces smaller incision than the SICS surgical technique, so that post-surgery rehabilitation is also shorter. The shorter rehabilitation time, which is only 7 days compared to the SICS surgical technique which requires 21 days recovery time, can save huge costs in the post-surgery stage.
The difference in recovery time also affects the lost productivity and the cost of companionship. Therefore, it can be said that although the SICS operating technique is less expensive in terms of surgery cost, it is still not much of a different from the Phacoemulsification technique. Based on the consideration of the total cost before surgery, during surgery, and after surgery, it can be concluded that the phacoemulsification cataract surgery technique is more cost-effective than the cataract surgery technique using SICS.
Author: Thinni Nurul Rochmah
The complete paper, Cost Effectiveness Analysis Betweeen Small Incision Cataract Surgery and Phacoemulsification, can be downloaded here:
