OBJECTIVES: This study aimed to assess the economic impact of intraocular lens (IOL) selection with intraoperative aberrometry (IOA) in cataract surgery compared to conventional preoperative biometry and planning (PBP) in Japan.

METHODS: A literature review of MEDLINE and Google Scholar was conducted to identify relevant studies published in peer-reviewed journals that reported on the clinical and refractive outcomes of IOA vs conventional PBP when surgeons selected IOL power. Outcomes of interest included proportions of patients with emmetropia (within ±0.5 diopters of target) or ametropia. Published and grey literature was used to parameterize the model for the Japan region, including reduction in enhancement surgeries (ie, excimer laser surgery, lens exchange, or lens rotation), and payments to the ophthalmologist. The economic analysis was completed in Excel.

RESULTS: All studies reporting absolute prediction error found eyes with IOA had numerically or significantly less error than those with PBP. The largest retrospective database analysis of 32,189 eyes showed a statistically significant 6% improvement in the proportion of patients achieving emmetropia with IOA versus PBP (81.9% vs 75.9%, P<0.0001). For an organization performing 1000 cases annually, the economic analysis predicted that IOA could help realize up to JAN¥ 13,841,130 in financial savings annually, or ¥ 13,841 per patient due to avoided enhancement procedures (approximately $128,000 and $128 USD respectively).

CONCLUSIONS: In this economic assessment conducted for the Japanese patient, IOA was predicted to contribute to cost-savings through follow-up procedural event avoidance. Reduced enhancement procedures can provide financial benefit to the practice, while patients with better refractive outcomes are likely to experience benefit through time and travel avoidance, and improved satisfaction.