OBJECTIVES: Posterior capsule rupture (PCR) is a cataract surgery complication that can occur for various reasons including standard metal phacoemulsification tips contacting the posterior capsule. A new polymer-coated tip uses a soft elastic material which aims to improve the safety profile of phacoemulsification. A targeted literature search was conducted to identify the associated benefits of this phacoemulsification tip and to calculate the potential cost impact of avoiding PCR events compared to a standard metal tip.

METHODS: PubMed was searched in June 2023 utilizing combinations of the following terms: phacoemulsification, cataract, posterior capsule rupture, INTREPID, balanced tip, hybrid tip, and polymer, and was limited to 2019-2023. Studies published in English investigating the INTREPID® Hybrid tip were included. Budget impact was estimated from a US healthcare provider perspective in a cohort of 1,000 patients using the associated healthcare resource utilization for treatment of PCRs (including additional operating room time, follow-up visits, medications, and procedures). Costs were informed based on published literature, where available, and reported in 2023 US dollars.

RESULTS: Five studies were identified (randomized observational=1; laboratory=4). The INTREPID® Hybrid Tip had a safer profile compared with the standard tip. The torsional power threshold to cause a PCR event was 2.2–3.4 times higher with Hybrid Tip compared with Balanced Tip in paired cadaver or porcine eyes (n=2 studies)Cumulative dissipated energy (CDE) outcomes were mixed; reported as lower (Grade 1-4 patient eyes) or similar (porcine lenses) CDE with Hybrid Tip (n=2 studies). The estimated PCR costs for Hybrid Tip and Balanced Tip were $58 and $163 per patient, respectively, for total cost savings of $105,676 across a hypothetical cohort of 1,000 patients.

CONCLUSIONS: Current literature suggests that the INTREPID® Hybrid Tip may minimize the risk of PCRs compared with Balanced Tip. However, future real-world evidence studies to assess this are warranted.