Cost Burden of Endothelial Keratoplasty in Fuchs Endothelial Dystrophy: Real-World Analysis of a Commercially Insured US Population (2014–2019)

Figures & data

Figure 1 Retrospective study design.

Table 1 Baseline Characteristics Captured 12 Months Before Index

Variable	Statistic or Category	Unadjusted (After First Round of Matching to Assign Synthetic EK Date Among Untreated)			Adjusted (After Second Round of Matching to Balance Baseline Characteristics)
		Endothelial Keratoplasty	No Keratoplasty	P value	Endothelial Keratoplasty	No Keratoplasty	P value
		(N = 1498)	(N = 14,559)		(N = 804)	(N = 1453)
Bullous keratopathy/corneal edema, N (%)	Yes	330 (22.03%)	327 (2.25%)	<0.001*	17 (2.11%)	18 (1.24%)	0.107
Cornea degeneration, N (%)	Yes	33 (2.20%)	199 (1.37%)	0.010*	7 (0.87%)	18 (1.24%)	0.424
Glaucoma, N (%)	Yes	354 (23.63%)	2472 (16.98%)	<0.001*	84 (10.45%)	123 (8.47%)	0.118
Cataract, N (%)	Yes	709 (47.33%)	4947 (33.98%)	<0.001*	329 (40.92%)	593 (40.81%)	0.960
Cataract Surgery, N (%)	Yes	187 (12.48%)	919 (6.31%)	<0.001*	61 (7.59%)	102 (7.02%)	0.618
Low vision/ blindness, N (%)	Yes	21 (1.40%)	88 (0.60%)	<0.001*	2 (0.25%)	2 (0.14%)	0.620
Visual Disturbances, N (%)	Yes	104 (6.94%)	679 (4.66%)	<0.001*	38 (4.73%)	66 (4.54%)	0.842
Prescription drug utilization
Used ophthalmic NSAIDs medication, N (%)	Yes	169 (11.28%)	731 (5.02%)	<0.001*	39 (4.85%)	59 (4.06%)	0.378
Used topical steroid medication, N (%)	Yes	135 (9.01%)	1371 (9.42%)	0.609	78 (9.70%)	113 (7.78%)	0.116
Used ophthalmic steroid medication, N (%)	Yes	378 (25.23%)	1375 (9.44%)	<0.001*	78 (9.70%)	113 (7.78%)	0.116
Used any IOP medication, N (%)	Yes	221 (14.75%)	838 (5.76%)	<0.001*	31 (3.86%)	36 (2.48%)	0.065
Used any topical antibiotic, N (%)	Yes	370 (24.70%)	2138 (14.69%)	<0.001*	117 (14.55%)	171 (11.77%)	0.058
All-cause prescription drug cost ($)	Mean (SD)	3458.31 (7338.53)	3368.11 (8966.35)	<0.001*	2937.31 (7478.41)	3022.20 (7046.30)	0.604
	Median (Q1 to Q3)	1219.54 (327.03 to 3967.83)	944.55 (214.78 to 3284.12)		803.91 (195.03 to 3203.94)	856.43 (215.19 to 3116.44)
	Range	0.00 to 146,565.0	0.00 to 231,508.9		0.00 to 146,565.0	0.00 to 90,261.31
Total medical cost burden related to (glaucoma, cataract, cystoid macular edema, and other potential cornea transplant complications) ($)	Mean (SD)	1451.00 (5171.08)	755.32 (3030.52)	<0.001*	647.28 (2191.59)	671.49 (2412.03)	0.480
	Median (Q1 to Q3)	196.15 (0.00 to 666.40)	43.63 (0.00 to 285.31)		0.00 (0.00 to 302.61)	41.04 (0.00 to 242.59)
	Range	0.00 to 106,877.8	0.00 to 97,659.93		0.00 to 28,541.86	0.00 to 37,440.50
Cost of claims flagged with diagnosis 3715/H185 Endothelial dystrophy ($)	Mean (SD)	394.25 (2078.52)	160.14 (990.07)	<0.001*	278.12 (1332.96)	133.28 (232.70)	<0.001*
	Median (Q1 to Q3)	138.35 (0.00 to 343.67)	42.32 (0.00 to 189.79)		97.46 (0.00 to 280.84)	72.90 (0.00 to 184.72)
	Range	0.00 to 46,842.92	0.00 to 88,233.31		0.00 to 25,694.87	0.00 to 3573.88

Note: *Indicates statistically significant.

Table 2 Cost and Health Care Utilization During Follow-Up Among Matched Cohorts

Variable	Statistic	Pre-Operative Period			12 Months Post EK			24 Months Post EK			36 Months Post EK
		Endothelial Keratoplasty	No Keratoplasty	P value	Endothelial Keratoplasty	No Keratoplasty	P value	Endothelial Keratoplasty	No Keratoplasty	P value	Endothelial Keratoplasty	No Keratoplasty	P value
		(N = 804)	(N = 1453)		(N = 804)	(N = 1453)		(N = 804)	(N = 1453)		(N = 804)	(N = 1453)
All-cause total cost	Mean (SD)	$4407 ($17,254)	$3801 ($10,501)	<0.001*	$41,199 ($82,308)	$20,222 ($56,259)	<0.001*	$58306 ($141,366)	$34,810 ($102,294)	<0.001*	$66,549 ($151,944)	$46,027 ($135,263)	<0.001*
All-cause inpatient cost	Mean (SD)	$528 ($5932)	$538 ($4047)	0.067	$3754 ($21,108)	$4411 ($21,810)	0.009*	$7742 ($31,977)	$7676 ($32,460)	0.118	$9140 ($34,897)	$10,874 ($38,776)	0.008*
All-cause outpatient cost	Mean (SD)	$2840 ($15,680)	$2342 ($8489)	<0.001*	$32,595 ($73,851)	$11,908 ($46,085)	<0.001*	$42,693 ($128,441)	$20,543 ($82,293)	<0.001*	$47,419 ($135,795)	$26,838 ($112,175)	<0.001*
All-cause prescription drug cost	Mean (SD)	$1039 ($2262)	$921 ($3727)	<0.001*	$4850 ($10,035)	$3903 ($9806)	<0.001*	$7871 ($17,681)	$6591 ($15,597)	<0.001*	$9990 ($24,870)	$8314 ($19,989)	<0.001*
Eye disease-related total cost	Mean (SD)	$1107 ($2361)	$403 ($1500)	<0.001*	$22,951 ($19,301)	$1389 ($3,934)	<0.001*	$25,085 ($20,489)	$2122 ($5,566)	<0.001*	$26,143 ($21,617)	$2445 ($5971)	<0.001*
Eye disease-related medical cost	Mean (SD)	$922 ($2334)	$365 ($1450)	<0.001*	$22,152 ($19,205)	$1226 ($3,764)	<0.001*	$24,008 ($20,332)	$1877 ($5,331)	<0.001*	$24,899 ($21,414)	$2143 ($5,668)	<0.001*
Eye disease-related prescription drug cost	Mean (SD)	$185 ($211)	$38 ($159)	<0.001*	$799 ($878)	$163 ($652)	<0.001*	$1076 ($1309)	$245 ($939)	<0.001*	$1244 ($1703)	$301 ($1166)	<0.001*
Complications-related medical cost	Mean (SD)	$662 ($1974)	$281 ($1229)	<0.001*	$11,029 ($15,629)	$815 ($2593)	<0.001*	$12,001 ($16,161)	$1201 ($3726)	<0.001*	$12,261 ($16,170)	$1354 ($3905)	<0.001*
Bullous keratopathy/corneal edema cost	Mean (SD)	$97 ($408)	$1 ($15)	<0.001*	$4794 ($10,239)	$6 ($78)	<0.001*	$5130 ($10,865)	$10 ($135)	<0.001*	$5314 ($11,294)	$13 ($177)	<0.001*
Endothelial dystrophy cost	Mean (SD)	$388 ($1113)	$61 ($126)	<0.001*	$17,645 ($16,738)	$222 ($1269)	<0.001*	$18,754 ($17,562)	$347 ($1628)	<0.001*	$19,255 ($18,485)	$390 ($1643)	<0.001*
Cost cataract surgery	Mean (SD)	$213 ($1074)	$131 ($853)	0.007*	$2074 ($4374)	$313 ($1407)	<0.001*	$2201 ($4398)	$400 ($1560)	<0.001*	$2239 ($4411)	$450 ($1653)	<0.001*
Healthcare utilization
Count of any office visits	Mean (SD)	5.15 (4.06)	4.36 (4.58)	<0.001*	22.42 (16.73)	19.10 (17.95)	<0.001*	34.11 (26.57)	31.20 (29.27)	<0.001*	40.84 (34.60)	38.69 (36.90)	<0.001*
Count of office visits for diseases of the eye and adnexa	Mean (SD)	2.05 (1.33)	0.66 (1.03)	<0.001*	7.25 (3.83)	2.16 (2.82)	<0.001*	9.34 (5.63)	3.25 (4.16)	<0.001*	10.30 (6.70)	3.90 (4.86)	<0.001*
Count of ophthalmologist visits	Mean (SD)	1.43 (1.19)	0.44 (0.87)	<0.001*	5.71 (4.01)	1.41 (2.21)	<0.001*	7.36 (5.49)	2.08 (3.14)	<0.001*	8.12 (6.43)	2.51 (3.87)	<0.001*
Used ophthalmic NSAIDs medication, N (%)	Yes	221 (31.3%)	42 (10.69%)	<0.001*	290 (36.07%)	78 (5.37%)	<0.001*	301 (37.44%)	93 (6.40%)	<0.001*	305 (37.94%)	102 (7.02%)	<0.001*
Used systemic steroid medication, N (%)	Yes	49 (6.94%)	102 (25.95%)	<0.001*	177 (22.01%)	338 (23.26%)	0.499	247 (30.72%)	467 (32.14%)	0.488	271 (33.71%)	531 (36.55%)	0.177
Used ophthalmic steroid medication, N (%)	Yes	32 (4.53%)	40 (10.18%)	<0.001*	92 (11.44%)	155 (10.67%)	0.572	136 (16.92%)	231 (15.90%)	0.531	161 (20.02%)	260 (17.89%)	0.213
Number of ophthalmic steroid medications, N (%)	Yes	505 (62.8%)	72 (4.96%)	<0.001*	708 (88.06%)	150 (10.32%)	<0.001*	712 (88.56%)	194 (13.35%)	<0.001*	714 (88.81%)	209 (14.38%)	<0.001*
Count of ophthalmic steroid medication	Mean (SD)	0.70 (0.62)	0.06 (0.28)	<0.001*	4.75 (3.44)	0.19 (0.67)	<0.001*	6.31 (4.82)	0.27 (0.97)	<0.001*	7.10 (5.82)	0.32 (1.14)	<0.001*
Dose of ophthalmic steroid medication (mg)	Mean (SD)	53.78 (54.06)	4.24 (22.85)	<0.001*	338.40 (265.48)	13.30 (62.55)	<0.001*	430.43 (343.96)	18.79 (79.59)	<0.001*	472.64 (394.53)	21.04 (85.86)	<0.001*
Used other steroid medication, N (%)	Yes	12 (1.70%)	30 (7.63%)	<0.001*	36 (4.48%)	72 (4.96%)	0.611	48 (5.97%)	92 (6.33%)	0.733	60 (7.46%)	116 (7.98%)	0.659
Number of steroid injections	Mean (SD)	0.12 (0.97)	0.41 (0.80)	<0.001*	0.69 (3.30)	0.56 (1.40)	0.205	0.99 (3.56)	0.92 (2.06)	0.466	1.14 (3.70)	1.12 (2.47)	0.609
Used any IOP-lowering medication, N (%)	Yes	42 (5.22%)	33 (2.27%)	<0.001*	155 (19.28%)	52 (3.58%)	<0.001*	177 (22.01%)	55 (3.79%)	<0.001*	184 (22.89%)	60 (4.13%)	<0.001*
Number of IOP-lowering medications	Mean (SD)	0.09 (0.44)	0.05 (0.40)	<0.001*	0.85 (2.54)	0.26 (1.99)	<0.001*	1.52 (4.33)	0.41 (3.15)	<0.001*	1.93 (5.90)	0.53 (3.94)	<0.001*

Note: *Indicates statistically significant at the 0.05 level.

Table 3 Prevalence of Potential Complications at Baseline and Over the Follow-Up Among Matched Cohorts

Variable	Baseline			Pre-OP Period			12 Months Post EK			24 Months Post EK			36 Months Post EK
	EK	Untreated	P value	EK	Untreated	P value	EK	Untreated	P value	EK	Untreated	P value	EK	Untreated	P value
	(N = 804)	(N = 1453)		(N = 804)	(N = 1453)		(N = 804)	(N = 1453)		(N = 804)	(N = 1453)		(N = 804)	(N = 1453)
Glaucoma, N (%)	84 (10.45%)	123 (8.47%)	0.118	124 (15.42%)	88 (6.06%)	<0.001*	242 (30.10%)	190 (13.08%)	<0.001*	280 (34.83%)	220 (15.14%)	<0.001*	286 (35.57%)	237 (16.31%)	<0.001*
Glaucoma Surgery, N (%)	2 (0.25%)	4 (0.28%)	>0.999	4 (0.50%)	4 (0.28%)	0.466	15 (1.87%)	10 (0.69%)	0.010*	17 (2.11%)	11 (0.76%)	0.005*	20 (2.49%)	12 (0.83%)	0.001*
Glaucoma shunt, N (%)	1 (0.12%)	0 (0.00%)	0.356	2 (0.25%)	1 (0.07%)	0.290	4 (0.50%)	1 (0.07%)	0.057	7 (0.87%)	2 (0.14%)	0.012*	8 (1.00%)	3 (0.21%)	0.021*
IOP, N (%)	1 (0.13%)	1 (0.07%)	>0.999	2 (0.25%)	2 (0.14%)	0.627	35 (4.35%)	6 (0.41%)	<0.001*	49 (6.09%)	8 (0.55%)	<0.001*	51 (6.34%)	10 (0.69%)	<0.001*
Cataract, N (%)	329 (40.92%)	593 (40.81%)	0.960	473 (58.83%)	287 (19.75%)	<0.001*	577 (71.77%)	620 (42.67%)	<0.001*	596 (74.13%)	712 (49.00%)	<0.001*	599 (74.50%)	744 (51.20%)	<0.001*
Cataract surgery, N (%)	61 (7.59%)	102 (7.02%)	0.618	52 (6.47%)	57 (3.92%)	0.007*	457 (56.84%)	112 (7.71%)	<0.001*	472 (58.71%)	145 (9.98%)	<0.001*	474 (58.96%)	158 (10.87%)	<0.001*
Cystoid macular edema, N (%)	2 (0.25%)	3 (0.21%)	>0.999	5 (0.62%)	13 (0.94%)	0.624	11 (1.37%)	24 (1.65%)	0.602	13 (1.62%)	25 (1.72%)	0.855	13 (1.62%)	25 (1.72%)	0.855
Dry eye ocular surface, N (%)	69 (8.73%)	186 (13.0%)	0.003*	66 (8.23%)	92 (6.63%)	0.163	119 (14.80%)	242 (16.66%)	0.250	146 (18.16%)	306 (21.06%)	0.099	165 (20.52%)	342 (23.54%)	0.100
Endophthalmitis, N (%)	0 (0.00%)	0 (0.00%)	NA	0 (0.00%)	0 (0.00%)	NA	3 (0.37%)	0 (0.00%)	0.045*	3 (0.37%)	0 (0.00%)	0.045*	3 (0.37%)	0 (0.00%)	0.045*
Globe rupture, N (%)	0 (0.00%)	0 (0.00%)	NA	0 (0.00%)	1 (0.07%)	>0.999	0 (0.00%)	1 (0.07%)	>0.999	0 (0.00%)	1 (0.07%)	>0.999	0 (0.00%)	1 (0.07%)	>0.999
Infectious keratitis, N (%)	1 (0.13%)	1 (0.07%)	>0.999	1 (0.12%)	0 (0.00%)	0.366	2 (0.25%)	0 (0.00%)	0.127	4 (0.50%)	0 (0.00%)	0.016*	5 (0.62%)	0 (0.00%)	0.006*
Infectious uveitis, N (%)	0 (0.00%)	3 (0.21%)	0.557	0 (0.00%)	4 (0.29%)	0.303	7 (0.87%)	9 (0.62%)	0.496	8 (1.00%)	10 (0.69%)	0.433	9 (1.12%)	10 (0.69%)	0.283
Persistent mydriasis, N (%)	0 (0.00%)	0 (0.00%)	NA	1 (0.12%)	0 (0.00%)	0.366	5 (0.62%)	0 (0.00%)	0.006*	5 (0.62%)	1 (0.07%)	0.024*	5 (0.62%)	1 (0.07%)	0.024*
Rejection of cornea Transplant, N (%)	0 (0.00%)	0 (0.00%)	NA	1 (0.12%)	0 (0.00%)	0.356	52 (6.47%)	3 (0.21%)	<0.001*	57 (7.09%)	3 (0.21%)	<0.001*	58 (7.21%)	3 (0.21%)	<0.001*
Retinal edema, N (%)	5 (0.62%)	2 (0.14%)	0.105	3 (0.37%)	4 (0.28%)	0.705	9 (1.12%)	9 (0.62%)	0.201	15 (1.87%)	10 (0.69%)	0.010*	16 (1.99%)	11 (0.76%)	0.010*
Suprachoroidal hemorrhage, N (%)	0 (0.00%)	0 (0.00%)	NA	0 (0.00%)	0 (0.00%)	NA	0 (0.00%)	1 (0.07%)	>0.999	1 (0.12%)	1 (0.07%)	>0.999	1 (0.12%)	1 (0.07%)	>0.999

Note: *Indicates statistically significant at the 0.05 level.

Table 4 Short Term Disability Payments and Days Missing from Work

All-Cause Short-Term Disability Payments ($)					All-Cause Short-Term Disability Days Missing From Work
Variable	Statistic	Endothelial Keratoplasty	No Keratoplasty	P value	Variable	Statistic	Endothelial Keratoplasty	No Keratoplasty	P value
		(N = 57)	(N = 103)				(N = 57)	(N = 103)
Baseline	Mean (SD)	59.04 (261.53)	267.62 (1793.82)	0.589	Baseline	Mean (SD)	1.47 (8.10)	3.26 (18.54)	0.516
Pre-op period	Mean (SD)	540.47 (4080.47)	33.97 (344.76)	0.664	Pre-op period	Mean (SD)	2.05 (15.50)	0.13 (1.28)	0.664
Day of EK	Mean (SD)	1325.03 (4790.06)	33.97 (344.76)	<0.001*	Day of EK	Mean (SD)	6.47 (18.65)	0.13 (1.28)	<0.001*
3-month follow-up	Mean (SD)	1495.49 (4913.38)	169.12 (1411.01)	<0.001*	3-month follow-up	Mean (SD)	7.02 (18.76)	0.76 (6.52)	<0.001*
12-month follow-up	Mean (SD)	2320.11 (7062.96)	668.24 (3837.26)	<0.001*	12-month follow-up	Mean (SD)	13.82 (35.69)	7.33 (45.58)	<0.001*
24-month follow-up	Mean (SD)	3277.76 (8343.59)	1200.20 (6265.28)	<0.001*	24-month follow-up	Mean (SD)	18.74 (40.83)	8.79 (47.31)	<0.001*
36-month follow-up	Mean (SD)	3421.97 (8464.03)	1430.10 (6527.97)	<0.001*	36-month follow-up	Mean (SD)	19.60 (41.82)	10.63 (49.08)	<0.001*
Eye disease-related Short-Term Disability Payments ($)					Eye disease-related Short-Term Disability Days Missing From Work
Baseline	Mean (SD)	27.83 (147.27)	0.00 (0.00)	0.057	Baseline	Mean (SD)	0.21 (1.18)	0.00 (0.00)	0.057
Pre-op period	Mean (SD)	540.47 (4080.47)	0.00 (0.00)	0.179	Pre-op period	Mean (SD)	2.05 (15.50)	0.00 (0.00)	0.179
Day of EK	Mean (SD)	1132.79 (4709.17)	0.00 (0.00)	<0.001*	Day of EK	Mean (SD)	5.23 (18.15)	0.00 (0.00)	<0.001*
3-month follow-up	Mean (SD)	1303.26 (4841.44)	135.15 (1371.63)	<0.001*	3-month follow-up	Mean (SD)	5.67 (18.32)	0.63 (6.40)	<0.001*
12-month follow-up	Mean (SD)	1436.14 (5065.12)	297.08 (3015.06)	<0.001*	12-month follow-up	Mean (SD)	6.61 (20.79)	1.31 (13.30)	<0.001*
24-month follow-up	Mean (SD)	1753.15 (6142.82)	297.08 (3015.06)	<0.001*	24-month follow-up	Mean (SD)	7.88 (24.15)	1.31 (13.30)	<0.001*
36-month follow-up	Mean (SD)	1773.50 (6142.89)	297.08 (3015.06)	<0.001*	36-month follow-up	Mean (SD)	8.00 (24.17)	1.31 (13.30)	<0.001*

Note: *Indicates statistically significant at the 0.05 level.

Table 5 Study Outcomes by 36 Months Since First EK, by Eye Treated

Variable	Category	Only One Eye Treated with No Postop Re-Treatment	Only One Eye Treated with Postop Re-Treatment	Both Eyes Treated	No Keratoplasty	P value
		(N = 276)	(N = 86)	(N = 222)	(N = 1453)
Prevalence of complications
Glaucoma, N (%)	Yes	89 (32.25%)	35 (40.70%)	69 (31.08%)	237 (16.31%)	<0.001*
Increased IOP, N (%)	Yes	14 (5.07%)	7 (8.14%)	16 (7.21%)	10 (0.69%)	<0.001*
Cataract, N (%)	Yes	178 (64.49%)	63 (73.26%)	195 (87.84%)	744 (51.20%)	<0.001*
Cystoid macular edema, N (%)	Yes	0 (0.00%)	4 (4.65%)	3 (1.35%)	25 (1.72%)	0.019*
Dry eye/ocular surface disease, N (%)	Yes	43 (15.58%)	16 (18.60%)	51 (22.97%)	342 (23.54%)	0.026*
Endophthalmitis, N (%)	Yes	1 (0.36%)	0 (0.00%)	0 (0.00%)	0 (0.00%)	0.094
Globe rupture, N (%)	Yes	0 (0.00%)	0 (0.00%)	0 (0.00%)	1 (0.07%)	0.940
Infectious keratitis, N (%)	Yes	0 (0.00%)	0 (0.00%)	2 (0.90%)	0 (0.00%)	<0.001*
Infectious uveitis, N (%)	Yes	3 (1.09%)	0 (0.00%)	2 (0.90%)	10 (0.69%)	0.746
Persistent mydriasis, N (%)	Yes	2 (0.72%)	1 (1.16%)	1 (0.45%)	1 (0.07%)	0.051
Cornea transplant Rejection, N (%)	Yes	9 (3.26%)	10 (11.63%)	21 (9.46%)	3 (0.21%)	<0.001*
Retinal edema, N (%)	Yes	7 (2.54%)	3 (3.49%)	3 (1.35%)	11 (0.76%)	0.014*
Suprachoroidal hemorrhage, N (%)	Yes	0 (0.00%)	1 (1.16%)	0 (0.00%)	1 (0.07%)	0.014*
Healthcare utilization
Anterior segment imaging, N (%)	Yes	49 (17.75%)	19 (22.09%)	63 (28.38%)	194 (13.35%)	<0.001*
Corneal pachymetry, N (%)	Yes	71 (25.72%)	24 (27.91%)	67 (30.18%)	184 (12.66%)	<0.001*
Glaucoma surgery, N (%)	Yes	7 (2.54%)	4 (4.65%)	3 (1.35%)	12 (0.83%)	0.004*
Cataract surgery, N (%)	Yes	122 (44.20%)	49 (56.98%)	180 (81.08%)	158 (10.87%)	<0.001*
Peripheral iridotomy/iridectomy, N (%)	Yes	1 (0.36%)	8 (9.30%)	19 (8.56%)	3 (0.21%)	<0.001*
Anterior segment surgery other than routine cataract and routine peripheral iridotomy/iridectomy, N (%)	Yes	13 (4.71%)	15 (17.44%)	17 (7.66%)	14 (0.96%)	<0.001*
Eye-disease related cost and short-term disability
Eye diseases related medical cost ($)	Mean (SD)	13,959.26 (9283.24)	28,378.19 (19,242.36)	31,358.89 (22,134.51)	2143.21 (5668.26)	<0.001*
Eye diseases prescription drug cost ($)	Mean (SD)	1041.61 (1894.27)	1666.78 (2141.94)	1221.47 (1184.68)	301.47 (1166.07)	<0.001*
		(N = 12)	(N = 10)	(N = 27)	(N = 103)
Eye disease related STD payments ($)	Mean (SD)	519.00 (899.88)	1353.32 (4279.57)	3012.15 (8440.26)	297.08 (3015.06)	<0.001*
Eye diseases related STD days missing from work	Mean (SD)	4.42 (7.10)	4.60 (14.55)	13.22 (33.24)	1.31 (13.30)	<0.001*

Note: *Indicates statistically significant at the 0.05 level.