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New research · Ophthalmology
BMC ophthalmology · 23h
Cohort studyBMC ophthalmology · 2026

Payer-perspective direct medical costs during observed postoperative follow-up after gonioscopy-assisted transluminal trabeculotomy versus mitomycin-augmented trabeculectomy in Turkey.

Cansu Yuksel Elgin, Mustafa Asim Erol
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OphthalmologyCohort study

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.

Cansu Yuksel Elgin et al. · BMC ophthalmology · 2026
Background

Glaucoma surgery has payer-budget implications when postoperative medication and procedure use differ between care pathways.

Purpose

This study compared direct medical costs after gonioscopy-assisted transluminal trabeculotomy (GATT) and mitomycin-C-augmented trabeculectomy (MMC-trabeculectomy) from the Turkish Social Security Institution (SGK) payer perspective.

Methods

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 GATT (n = 40) or MMC-trabeculectomy (n = 20).

cost ratio 2.01; 95% CI, 1.50-2.70
Results
direct medical costs for MMC-trabeculectomy are approximately double those for gonioscopy-assisted transluminal trabeculotomy
More results

Mean primary base-case direct medical cost was 3188.6 ± 1955.9 TRY after GATT and 6835.8 ± 4674.5 TRY after MMC-trabeculectomy.

Glaucoma-related non-routine procedure costs were 0.0 TRY per GATT patient and 271.1 TRY per MMC-trabeculectomy patient.

“
Conclusion · 1 of 3

In this Turkish SGK payer-perspective analysis, MMC-trabeculectomy was associated with higher observed direct medical costs than GATT during available postoperative follow-up.

Conclusion · 2 of 3

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.

Conclusion · 3 of 3

They should not be interpreted as a long-term cost-utility analysis or causal evidence of economic superiority.

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