2019 № 3 Cost performance of the selective laser trabeculoplasty for patients with primary open-angle glaucoma
Primary open-angle glaucoma, as the most common form of glaucoma, is an important medico-social problem. Selective laser trabeculoplasty is an effective and safe method of treatment of primary open-angle glaucoma. The purpose of this work was to estimate the cost performance of the treatment of patients with primary open-angle glaucoma using selective laser trabeculoplasty and their stagewise dynamics during the treatment. The analysis of 250 patients (338 eyes) with primary open-angle glaucoma, operated using selective laser trabeculoplasty in the Orenburg branch of S. Fyodorov Eye Microsurgery Federal State Institution of the Ministry of Health of the Russian Federation, was carried out. The patients are from 42 to 86 years old, of which 118 are women (47.2%) and 132 are men (52.8%), all of them being residents of the Orenburg region. Intraocular pressure before selective laser trabeculoplasty ranged from 20 to 30 mm Hg. All the patients attended standard ophthalmological examination before the operation. Selective laser trabeculoplasty was performed on the apparatus Quantel Medical Optimis with Solutis attachment at standard parameters. During the postoperative period, nonsteroidal anti-inflammatory drugs were prescribed to the patients for 7 days. The follow-up period after selective laser trabeculoplasty: 1 day; 1, 3, 6, 12 months. The linear method and cluster analysis were used as mathematical methods; the processing was carried out using STATISTICA 10 software package. Statistical analysis was performed on subsamples drawn on the basis of qualitative characteristics: gender code; age code; code “working/not working”; disease severity code; OD diagnosis code and OS diagnosis code. All 250 patients were divided into 5 clusters with the help of cluster analysis applied to the characteristics listed above. Clusters, in which patients have the lowest and the highest average expenditures for antihypertensive drugs for the entire period of treatment, were identified. The results of cluster analysis can be the basis for constructing a model of the average estimated expenses of patients with primary open-angle glaucoma operated with selective laser trabeculoplasty. Determining the ratio of material expenditures and the result of treatment allows to effectively plan ophthalmological care for patients with primary open-angle glaucoma.