Cost Effectiveness Of The Management Of Ocular Surface Disease Involving Inflammation And Persistent Epithelial Defects Utilising Various Treatment Modalities.

To report the outcomes and cost effectiveness of patients who have undergone conventional treatment for ocular surface inflammation with or without persistent epithelial defects

Retrospective

In a retrospective audit across two UK NHS centres; Queen Victoria Hospital Foundation Trust, East Grinstead, and Maidstone and Tunbridge Wells Trust, Kent, 30 eyes of 30 patients (17 male, 13 female) were treated with conventional measures (lubricants (30), topical antibiotics (30), topical steroids (30), systemic immunosuppression (9) , plasma drops (8), bandage contact lens (22) , tarsorrhaphy (25) and surgical management (2) ). The audits main outcome was resolution of the epithelial defect, number of clinic appointments till final outcome, number and cost of concomitant treatment. 

 Eleven patients of limbal stem cell deficiency including 6 patients with chemical injury, 6 patients microbial keratitis and 6 patients neurotrophic corneal disorders and 8 post keratoplasty patients were included in the study. The number of days between first presentation and final outcome was 176 ± 188 (range 15-959). The mean number of outpatient appointments between first presentation and final outcome were 10 ± 4 (range 4-21). The mean combined cost of prescribed medications / visit was £ 198 ± 186 (range 34-681). The cost per patient (excluding the clinic appointment costs to NHS) from first presentation to final appointment assuming medications were prescribed at each visit was  £ 2551 ± 1708 (range 725-6597).  

Management of ocular surface disease involving ocular surface inflammation with or without persistent epithelial defects carries a significant cost burden to health services. Timely interventions in suitable patients could save significant patient visits and costs of concomitant treatment.