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Supported by unrestricted grants from the Dr. F.P. Fischer Foundation (DG, RW), facilitated by the Foundation Friends from the UMC Utrecht.
The authors have no financial or proprietary interest in the materials presented herein.
To the Editor:
Although corneal cross-linking (CXL) for keratoconus is increasingly applied, there is limited evidence on the costs of this treatment. One cost-effectiveness study estimated the costs of the total CXL treatment for one simulated patient as £928 ($1,392 U.S.). 1 In our study, we assessed the costs of CXL in clinical practice, including preoperative eligibility assessments and 1-year follow-up.
All consecutive patients referred for keratoconus to our tertiary referral center between September 2012 and July 2013 were included. Surgical treatment was performed according to the Dresden protocol (3 mW/cm 2 irradiation for 30 minutes). Inclusion and exclusion criteria were described previously. 2 All costs of preoperative consultation, surgical procedure, and postoperative costs during 1 year of follow-up were assessed from the health care perspective, following a microcosting approach in concordance with Dutch guidelines for health economic research. 3 Equipment costs were based on purchase value, annual volume, and a 10-year depreciation. Costs of medication were obtained from the Dutch Healthcare Institution. 4 All costs were converted to 2015 Euros and an exchange rate of 1.10 to U.S. dollars was applied.
A total of 43 patients (86 eyes) were included in this study. Twenty-eight eyes of 20 patients were scheduled for CXL treatment. The mean age of treated patients was 20.2 years and mean uncorrected and corrected visual acuity of treated...