Corneal transplants restore sight and save healthcare dollars

Robin Wulffson MD's picture
Corneal transplants are cost effective

Eye disorders are the fifth costliest to the U.S. economy after heart disease, cancer, emotional disorders, and pulmonary conditions. Corneal transplants have a high success rate and, overall, has a total lifetime net benefit of nearly $6 billion.

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Vision is a priceless asset; however, delicate eye surgery that can restore vision often comes at a high price. Eye disorders are the fifth costliest to the U.S. economy after heart disease, cancer, emotional disorders, and pulmonary conditions. Some eye problems cannot be reversed, even by an ophthalmologist skilled in surgical procedures; however, others have a high success rate. One of these is corneal transplantation. According to Chris Hanna, Executive Director of the Utah Lions Eye Bank, the procedure has a high success rate and, overall, has a total lifetime net benefit of nearly $6 billion. He also informed me of a number of facts that many individuals may not be aware of.

Hanna told me that a corneal transplant costs between $15,000 and $20,000; however, the good news, the procedure is covered by many health insurers, including Medicare. This point is of particular import importance, because the majority of individuals in need of a corneal transplant are in their senior years. He noted that a six-month study undertaken by the Eye Bank Association of America (EBAA) found that corneal transplants performed in the United States this year will result in nearly $6 billion in total net benefits over the lifetime of the recipients. His facility, located at the John A. Moran Eye Center has been an EBAA member since 1972 and will provide over 900 corneas for transplant this year, with an estimated lifetime value of $76,543,987.

The study compared the medical cost of transplant procedures to the direct and indirect lifetime costs of the alternative: living with blindness or severe vision impairment. With a corneal transplant, an individual avoids the direct expenditures that come with vision loss, such as higher routine medical costs and long-term care costs, and the indirect costs of potential years of lost productivity to both the patients and their family caregivers.

It is common knowledge that many transplantation procedures are impacted by donor rejection and lack of availability. Hanna told me that this is not the case for corneal transplantation. The cornea lacks blood vessels and rarely invokes an immune response. The success rate stands at an impressive 95% and, if a failure occurs, the patient may be eligible for a repeat procedure. Other good news is that, thanks to state-run programs, there is no waiting list for an individual requiring a transplant. Hanna said, “On behalf of all cornea transplant recipients our eye bank has been honored to serve, I extend a deep and sincere appreciation for the donors and their families who, without their decision to donate, none of this would be possible.”

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The Eye Bank Association of America commissioned this study to determine the economic impact of corneal transplants. Researchers used previous years’ transplant numbers and census data to estimate total corneal transplants for the full 2013 calendar year. The cost-benefit analysis revealed that the lifetime benefit of the procedure is overwhelmingly greater than the costs of the surgery.

The cornea is the transparent, dome-shaped surface of the eye that accounts for a large portion if its. A cornea transplant, also called keratoplasty, can restore vision, reduce pain, and improve the appearance of a damaged or diseased cornea. It is typically performed as an outpatient procedure. During the most common type of cornea transplant (penetrating keratoplasty), the ophthalmologist cuts through the entire thickness of the abnormal or diseased cornea to remove a small button-sized disc of corneal tissue. A trephine, which resembles a miniature cookie cutter is used to make this precise circular cut. The donor cornea is cut to fit and placed in the opening. The surgeon then uses a fine thread to stitch the new cornea into place. With some types of cornea problems, a full-thickness cornea transplant is not always the best treatment. Partial-thickness (lamellar) transplants may be used in certain situations.

Chris Hanna has served the eye banking community for over 15 years. Before moving to Utah in 2006 from his hometown Houston, Texas, he spent four years as the Executive Director of the Lions Eye Bank of Texas at Baylor College of Medicine and currently serves as the Executive Director of the Utah Lions Eye Bank at the John A. Moran Eye Center.

Chris has played an active role in the Eye Bank Association of America serving in several professional capacities including the co-chair of the Accreditation Board, a member of the Medical Review Subcommittee, and consultant on the Medical Advisory Board.

Chris earned his undergraduate degree in Biology and Psychology from Houston Baptist University in 1998, and has published papers in Investigative Ophthalmology and Visual Sciences as well as Cornea. More recently, Chris earned his master's degree for business administration from the Executive MBA program at the University of Utah.

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