[An observational, retrospective two-year cost study in primary open-angle glaucoma and ocular hypertension in newly diagnosed patients]. / Etude observationnelle rétrospective de coûts des deux premières années de traitement dans le glaucome primitif à angle ouvert et l'hypertension oculaire en France.

PURPOSE: To investigate the different treatment strategies in France and the direct costs for patients with newly diagnosed primary open-angle glaucoma or ocular hypertension who have started treatment with beta-blockers, and to estimate the total direct cost for two years of treat. MATERIAL: and methods: We analyzed 225 medical charts retrospective in eleven academically and office-based centers in France over the first two years after diagnosis. Standard costs for each resource in current medical practice were determined from the French Social Security perspective. RESULTS: The vast majority of patients (90%) had a diagnosis of primary, open-angle glaucoma or ocular hypertension in both eyes. In 60% of the patients we found a moderate or severe defect in their visual field or optic nerve. Intraocular pressure before treatment was 23.9+4.7mmHg and 17.5+4.2mmHg after two years of treatment. Over the first two years, 25% of visits led to a change in therapy (medical or surgical), involving 64% of the patients. Two-thirds of the changes occurred during the first year of treatment and in around 80% of cases for low intraocular pressure at check-up. Laser surgery or surgical intervention was performed in 25% of the patients. Total direct costs for two years were 5698F.F. The intraocular pressure before treatment was positively correlated (p<0.01) with treatment costs, while the initial intraocular pressure-lowering effects of treatment were negatively correlated with two-year costs. CONCLUSION: After two years of treatment, the mean intraocular pressure decreased from 24 to 17.5mmHg. The higher the basal intraocular pressures is, the more intensive the treatment and the higher the costs. The more efficient the treatment to decrease baseline intraocular pressure is, the earlier the costs will be reduced.

[Anesthesia for cataract surgery. Result of a national survey]. / Anesthésie pour chirurgie de la cataracte. Resultat d'une enquête nationale.

OBJECTIVES: In order to evaluate the impact of recent progress in anesthesia and cataract surgery, we conducted a national survey in France to determine which techniques are used. METHODS: A questionnaire was sent to the most representative French ophthalmology teams: 66 teams participated in the survey. RESULTS: Seventy-one percent of the surgeons routinely used phacoemulsification: 91% of the anesthesists prefer locoregional anesthesia: contraindications most often involved general health status (89%). Ambulatory anesthesia was preferred by 16.7% of the teams. CONCLUSION: Phacoemulsification under peribulbal anesthesia is currently the technique most frequently used in cataract surgery in France. Ambulatory anesthesia is not yet widely used for this type of surgery.