Payer-perspective direct medical costs during observed postoperative follow-up after gonioscopy-assisted transluminal trabeculotomy versus mitomycin-augmented trabeculectomy in Turkey.
Mitomycin-C-augmented trabeculectomy is associated with higher direct medical costs than gonioscopy-assisted transluminal trabeculotomy.
Payer-perspective direct medical costs during observed postoperative follow-up after gonioscopy-assisted transluminal trabeculotomy versus mitomycin-augmented trabeculectomy in Turkey.
Glaucoma surgery has payer-budget implications when postoperative medication and procedure use differ between care pathways.
This study compared direct medical costs after gonioscopy-assisted transluminal trabeculotomy (gonioscopy-assisted transluminal trabeculotomy) and mitomycin-C-augmented trabeculectomy (MMC-trabeculectomy) from the Turkish Social Security Institution (SGK) payer perspective.
This single-centre retrospective cohort used patient-level chart, operating-room, and medication-cost data from sequentially reviewed surgery-naive adults with primary open-angle or pseudoexfoliation glaucoma who underwent gonioscopy-assisted transluminal trabeculotomy (n = 40) or MMC-trabeculectomy (n = 20).
Mean primary base-case direct medical cost was 3188.6 ± 1955.9 TRY after gonioscopy-assisted transluminal trabeculotomy and 6835.8 ± 4674.5 TRY after MMC-trabeculectomy.
Glaucoma-related non-routine procedure costs were 0.0 TRY per gonioscopy-assisted transluminal trabeculotomy patient and 271.1 TRY per MMC-trabeculectomy patient.
In this Turkish SGK payer-perspective analysis, MMC-trabeculectomy was associated with higher observed direct medical costs than gonioscopy-assisted transluminal trabeculotomy during available postoperative follow-up.
The findings are limited by the retrospective single-centre design, imbalanced groups, nonrandomized surgical selection, no propensity-score matching or inverse-probability weighting, and short follow-up for long-term durability.
They should not be interpreted as a long-term cost-utility analysis or causal evidence of economic superiority.