Cost Effectiveness of Limited Vitrectomy for Vision Degrading Myodesopsia

Purpose Patients afflicted with clinically significant vitreous floaters suffer from Vision Degrading Myopdesopsia , characterized by impairments in contrast sensitivity function (CSF) and decreased quality-of-life. This study determined the cost-utility of limited vitrectomy for this condition. Design Retrospective, interventional case series and third party insurer cost-utility analysis. Methods Sixty-seven patients suffering from unilateral vitreous floaters [20 non-myopes with posterior vitreous detachment (PVD); 17 myopes (>-2D) without PVD; 30 myopes with PVD] completed the NEI Visual Function Questionnaire (VFQ-39) and were tested with best-corrected visual acuity (BCVA) and contrast sensitivity function (CSF) measurements before and after limited vitrectomy. A reference case cost-utility analysis was performed. Results The mean VFQ-39 increased 19% (p Conclusions Limited vitrectomy for Vision Degrading Myodesopsia is clinically effective, in that it improves BCVA, CSF, and patient well-being. It is also highly cost-effective ($1,574/QALY), with an average cost-utility ratio versus no therapy that is superior to cataract surgery ($2,262/QALY), amblyopia therapy ($2,710/QALY), and retinal detachment repair ($45,304/QALY). Myopes without PVD had the lowest cost-utility ratio of all ($1,338/QALY).