This study is a descriptive study, with a cross-sectional approach.The cost effectiveness of cataract surgery by the ECCE and Phaco techniques are assesed on the clinical outcome of the treatment, The occurrence of complications, the visual acuity (VA), the visual function (VF), the ability to do activities of daily life, and cost/QALY quotient (Quality adjusted life years). The target populations were cataract patients who were treated at the Mettapracharak hospital(Wat Raiking ). Random sampling was used to select 40 cataract patients operated on using the Phaco technique, and purposive selection was used for selecting 40 cataract patients operated on using the ECCE technique. The information was obtained from June 2004 to September 2004. Descriptive statistical methods were used for the assessment of the demographic and the socio-economic situation, frequencies was calculated as well as percentages, means and standard deviations. Maximum and minimum values are also given. For analytical statistics the t-test had been performed for analyzing the relationship between visual function and ability to do everyday activities. The result of the study revealed, that the cost of cataract surgery by the Phaco technique is 5,242.76 Baht/person which is higher than for the ECCE method (3,542.1 Baht/person). The costs of cataract surgery are mostly due to the costs of medicine and medical supplies. Cataract surgery by the ECCE method includes a high risk of astigmatism which was not found for the cataract patients operated on using the Phaco technique. After treatment, the visual acuity (VA) of the patients operated on using the Phaco technique was 20/20. The visual acuity of patients operated by the ECCE technique was 20/70. There was statistically significant difference (p-value =0.05) between the visual functions (VF) of both groups of patients (p-value = 0.035) and there was statistically significant difference (p-value =0.05) in the ability to perform activities of daily life between the Phaco- and the ECCE group of patients (p-value = 0.01). Recommendations are directed to the medical management related to the health personnel, and the medical supply should be improved in order to decrease the cost of cataract surgeries. The benefits received from using the new technique should be studied in more details. Use of the new technique for mass cataract surgery should be encouraged and supported should be given for the manufacturing of some of the medicines and medical supplies within the country under observing quality control measures.

M.A. MEDICAL AND HEALTH SOCIAL SCIENCES คณะ FACULTY OF SOCIAL SCIENCE AND HUMANITIES มหาวิทยาลัยมหิดล ปี 2548

cataract, surgery, cost effectiveness, ECCE, PHACO