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Higher Costs, Utilization for Patients With Exfoliation Glaucoma

April 26, 2019

A recent study found that both health care resource utilization and costs are higher for patients with exfoliation glaucoma compared to patients with primary open-angle glaucoma.  

In order to understand the differences in utilization and cost among patients with exfoliation glaucoma or primary open-angle glaucoma, a team of researchers identified Medicare beneficiates with either eye disease and 5 or more years of continuous enrollment from January 2008 to December 2014.  

“We distinguished newly diagnosed cases from those with preexisting disease. We compared ophthalmic resource utilization and costs over 2 years of follow-up for persons with newly diagnosed and preexisting [exfoliation glaucoma] vs those with [primary open-angle glaucoma]” said lead author Siddarth Rathi, MD, MBA, Department of Ophthalmology, New York University School of Medicine, and colleagues. “Main outcome measures were number of clinic visits, diagnostic procedures, medication fills, laser and incisional surgery, and mean eye care costs per beneficiary.” 

The researchers identified 192 eligible enrollees (median age 77.6 year) with newly diagnosed exfoliation glaucoma, and 7339 enrollees (median age 77.3 years) with newly diagnosed primary open-angle glaucoma.

According to the findings, patients with exfoliation glaucoma had more office visits, cataract surgery, and glaucoma surgery. Further, this cohort also experienced 27% higher mean total eye care costs over 2 years of follow-up ($3260 vs $2562). Additionally, Dr Rathi and colleagues found that among 2745 enrollees with preexisting exfoliation glaucoma and 89,036 patients with preexisting primary open-angle glaucoma, those with exfoliation glaucoma had a higher number of office visits, perimetry, cataract surgery, laser trabeculoplasty, and trabeculectomy. Finally this cohort experienced higher told mean eye care costs ($3764 vs $2739).   

“Healthcare resource utilization and costs are substantially higher for managing patients with [exfoliation glaucoma] compared to [primary open-angle glaucoma],” Dr Rathi and colleagues concluded.

Julie Gould 


Rathi S, Andrews C, Greenfield DS, Stein JD. A Comparison of Resource Use and Costs of Caring for Patients With Exfoliation Syndrome Glaucoma Versus Primary Open-Angle Glaucoma [published online April 2019]. Am J Ophthal. DOI:

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