OBJECTIVES: The purpose of the study is to compare the clinic chair time and revenue due to YAG laser capsulotomy and its complications associated with five single-piece hydrophobic acrylic IOLs (AcrySof, Hoya Vivinex iSert, B&L Envista MX60, J&J Tecnis ZCB00 and Zeiss CT Lucia) at a private ophthalmology centre in India, and to explore potential revenue opportunity by reinvesting the YAG procedure chair time to other procedures over 5 years.

METHODS: YAG laser capsulotomy incidence and risk probability of post-Nd:YAG laser complications was derived using pooled evidence from published literature. Annual cataract procedures (N=25,000), chair time and center fee for YAG procedure and any subsequent procedures to treat YAG laser complications, chair time and center fee for conducting other ophthalmology procedures (anti-VEGF injection, LASIK, and successful patient counselling on advanced Technology IOL (ATIOL) procedure), were informed by surgeon inputs. Analysis was conducted using cost-consequence approach.

RESULTS: The model demonstrates use of AcrySof IOLs could save chair time (range: 487-3,334 hours) compared to other 4 IOLs (Hoya Vivinex iSert, B&L Envista MX60, J&J Tecnis ZCB00 and Zeiss CT Lucia) due to lower need for YAG procedures and any subsequent procedures to treat YAG laser complications at the center over 5. Our analysis shows although this could lead to the loss of YAG procedure revenue for the center, the saved YAG procedure chair time if re-invested in performing other ophthalmology procedures (Anti-VEGF injection, LASIK or ATIOL counselling), could potentially result in higher overall center revenue (Low end =INR 8.1 million; Upper end=INR 333.8 million).

CONCLUSIONS: The probability of performing YAG capsulotomy procedure is linked to the choice of IOL implant and impacts clinic chair time with a limited revenue potential. Choosing AcrySof IOL could reduce the need for YAG procedure and saved chair-time which could be utilized in performing other ophthalmology procedures with higher revenue potential.