Purpose: To estimate global incidence and prevalence trends of keratoconus (KC). Methods: A systematic review and meta-analysis was conducted using MedLine, Embase, and Scopus databases up to January 2024, including all age groups, sexes, and geographic regions. Pooled incidence and prevalence were estimated using random-effects models, with heterogeneity assessed by χ² and I² statistics. Results: This study included 55 studies (53 in meta-analysis). Pooled KC prevalence was 289.1 per 100,000 persons [95% confidence interval (CI) 124.2–671.1] or 0.24% of the population. The pooled incidence was 4.0 per 100,000 person-years (95% CI 2.5–6.3). Males had higher odds of KC compared with females (odds ratio 1.10; 95% CI 1.07–1.13). The 20 to 29 age group had the highest prevalence (525.5 per 100,000 persons; 95% CI 92.6–2822.6) and incidence (20.8 per 100,000 persons-years; 95% CI 12.7–24.1). Prevalence was highest in Africa (2414.2 per 100,000 persons; 95% CI 110.1–1421.5). Prevalence estimates varied significantly across Asian subregions, with lowest prevalence observed in East Asia (12.7 per 100,000 persons; 95% CI 2.81–57.0) and substantially higher rates in West (682.0 per 100,000 persons; 95% CI 141.8–3213.1) and South Asia (1374.5 per 100,000 persons; 95% CI 537.2–3471.5). Prevalence and incidence increased over time, with highest prevalence post-2020 (1155.2 per 100,000 persons; 95% CI 32.4–29682.7) and highest incidence in 2015 to 2019 (15.23 per 100,000 person-years; 95% CI, 8.5–27.3). Conclusions: Over 23.7 million individuals globally are affected by KC, highlighting an increasing global burden of KC and emphasizing the need for further research into temporal and regional patterns to inform public health strategies and optimize patient care.

Objective: To evaluate the frequencies of input parameters in cost-effectiveness analyses (CEA) within ophthalmology, particularly in willingness-to-pay (WTP), and to assess trends over time in studies conducted in the United States. Methods and analysis: A cross-sectional analysis of CEAs from the Tufts Medical Center CEA Registry spanning 1993 to 2022 was conducted, including all studies evaluating diseases of the eye and adnexa. The primary outcomes measured included trends in WTP thresholds, funding sources, types of interventions and disease classifications. Results: A total of 82 US-based CEAs met the inclusion criteria. All studies assessed outcomes in quality-adjusted life years (QALYs). WTP thresholds of US$50 000 (41%) and US$100 000 (39%) were most frequently reported, with US$150 000 emerging in 9% of studies since 2019. Discounting at 3.0% for costs and QALYs was universally applied. Government (33%), nonprofit (29%) and pharmaceutical (17%) funding predominated. Pharmaceutical-funded studies often employed higher WTP thresholds of US$100 000 (29%) and US$150 000 (29%). The most common intervention types were surgical (40%) and pharmaceutical (40%), whereas diseases of the choroid and retina (43%) were most frequently studied. Healthcare perspectives (17 studies) were more commonly reported than societal perspectives (6 studies). Conclusions: US-based ophthalmology CEAs commonly use US$50 000–$100 000 WTP thresholds and a 3.0% discount rate, with higher thresholds emerging recently. Public and nonprofit funding predominates, focusing on retinal diseases and surgical or pharmaceutical interventions. Reassessing fixed WTP thresholds and incorporating societal perspectives could improve CEAs’ relevance, ensuring alignment with evolving economic and healthcare landscapes.

Background: Social determinants of health (SDH), such as socioeconomic status, education, healthcare access, and social support, play a significant role in shaping individuals lived experiences. Dual sensory loss (DSL), a distinct disability involving both vision and hearing loss, poses greater challenges for daily living compared to the general population. This scoping review synthesized evidence on how various SDH indicators influence the life experiences of older adults with DSL. Methods: Five scientific databases were searched from January 2014 to May 2024. Articles focusing on individuals aged 60 and older with DSL, in the context of at least one SDH indicator, were included. Results: A total of 69 studies met the eligibility criteria. Most studies addressed the following SDH indicators: disability (n = 46), social inclusion and non-discrimination (n = 21), gender (n = 10), and access to healthcare services (n = 9). Disability-related indicators revealed higher risks of mobility limitations, cognitive decline, depression, anxiety, social isolation, and workplace discrimination, all adversely affecting mental health and quality of life. Older adults with DSL encounter significant barriers to accessing healthcare, such as absence of adequate assistive devices, communication challenges, and high healthcare costs. Many report dissatisfaction with the quality of care received. Conclusions: Our review identifies disparities that increase the vulnerability of older adults with DSL and restrict their access to healthcare, rehabilitation, and social participation. These findings warrant further research on underexplored SDH factors, using robust data sources that collects information on the lived experiences of older adults with DSL. Addressing these social determinants requires a comprehensive approach, including raising awareness, improving service access, enhancing social support networks, and ensuring inclusive policies and practices.

This study aimed to evaluate the cost-effectiveness of injectable human corneal endothelial cell therapy, known as cultured human corneal endothelial cells (hCEC), compared to the current standard of Descemet stripping (automated) endothelial keratoplasty (DSAEK) and Descemet membrane endothelial keratoplasty (DMEK) for endothelial dysfunction using an economic simulation model. In this Monte Carlo simulation cost-utility analysis, injectable hCEC therapy versus DSAEK/DMEK costs and effects were projected over a lifetime horizon for a simulated cohort of adult patients (≥18 years old), requiring endothelial keratoplasty in theoretical surgical centres in Ontario, Canada. Procedural wait times, effectiveness (quality-adjusted life year), and cost (2025 Canadian dollars) values were obtained from the literature and discounted at 3% per year. A cost-effectiveness threshold of incremental cost-effectiveness ratio ≤ $50,000 per quality-adjusted life year (QALY) gained was applied as a criterion for determining the economic viability of the interventions. The patient population consisted of 35,222 adults (estimated prevalence of endothelial dysfunction in Ontario). The preoperative wait time (days) was 102.99 (5.17) and 173.99 (5.54) for hCEC and DSAEK/DMEK, respectively. The life-time costs for hCEC and DSAEK/DMEK were $18,139.03 (SD 1,040.93) and $11,039.38 (SD 531.78), respectively. The expected lifetime QALYs were higher for those receiving hCEC (11.76; SD 2.74) relative to DSAEK/DMEK (9.16; SD 3.22). The incremental cost-effectiveness ratio for hCEC therapy against DSAEK/DMEK was $2,715.59 per QALY. The threshold analyses indicated that hCEC would be the dominant cost-effective option with a cost equal to or less than $10,000. Injectable hCEC therapy is a cost-effective option when compared to DSAEK/DMEK for endothelial dysfunction in this simulation model. The implementation of injectable hCEC therapy has the potential to improve clinical outcomes and increase accessibility for patients with endothelial dysfunction globally.

Background: Mild cognitive impairment (MCI) is a precursor to dementia, with a prevalence of over 15% among community dwellers, with significant economic and social implications. Despite preserved autonomy in daily living, individuals with MCI face challenges in handling everyday technology and memory-related tasks, necessitating digital interventions, such as digital planning-based technologies to support cognitive functioning. Objective: The aim of this study is to identify and summarize available research literature on available digital planning-based technologies to support memory-related functioning in older adults with MCI. Specifically, this study seeks to (1) document the types and functions of these technologies, (2) report their effectiveness, and (3) identify gaps in the current evidence. Methods: A comprehensive literature search of four databases (Medline, Embase, APA PsycINFO, and CINAHL) was conducted in accordance with Arksey and O’Malley’s scoping review methodological framework from inception to February 6, 2024, without restrictions. Inclusion criteria focused on peer-reviewed studies involving adults aged 50 or older with diagnosed cognitive impairment, specifically using digital planning-based technologies for memory support. Results: From 1854 sources, 8 studies were included. Five categories of digital planning-based technologies were identified: (1) reminders and alarms, (2) electronic calendars, (3) digital memory notebooks, (4) digital visual mapping, and (5) smart-home integration. Several studies reported improved task performance, memory recall, and executive function, with digital memory notebooks and visual mapping software showing greatest impact on functional independence. While interventions were generally well-received, usability challenges and low adherence were common, often linked to technological familiarity and motivation. Conclusions: Digital planning-based technologies show promise in supporting memory-related functioning in older adults with MCI. While studies report positive outcomes, more research is needed to refine these tools, evaluate long-term effects, and ensure integration into daily life. Expanding the evidence base will be key to improving accessibility and effectiveness for this population.