Ilona Kruntorádová, Klára Kruntorádová, Vladimír Rogalewicz, Miroslav Barták OBJECTIVES: In the Czech Republic, 7% of patients with senile cataract are indicated for surgery each year, which means ten thousand of interventions annually. The aim of this study is to quantify direct costs in relation to the implanted intraocular lens type from both the public health insurance perspective and the patient’s perspective. The senile cataract surgery with monofocal IOL is covered by public health insurance.  METHODS: Direct costs were calculated through a panel of experts that provided expert opinions, taking into account consumption of paid medical services provided to patients. The panel consisted of 6 experts (4 physicians from eye clinics, 2 physicians from outpatient departments). Patient´s costs were obtained through a patient questionnaire asking the direct (out-of-pocket) expenses associated with the cataract. The study covered a cohort of 200 patients with senile cataract in non-productive age (65+). Data were collected from 4 clinics performing cataract surgery.  RESULTS: The structure of direct costs associated with senile cataract, its surgery, and treatment of possible complications has been specified. Direct costs of senile cataract surgery from the perspective of public health insurance are CZK24900 (»EUR907) per person. Patient´s direct costs are lower for monofocal lenses than for multifocal ones. Patients’ costs for an IOL and the related treatment reach up to CZK35000 (»EUR1275), out of pocket expenses after treatment average out at CZK4450 (»EUR162).  CONCLUSIONS: Due to absence of laws governing medical care premium services and the age of patients, monofocal IOLs are implanted predominantly. As a consequence, up to CZK 30 million (»EUR 1 1 million) are saved on the public health insurance budget annually. Patients´ expenses for implanting multifocal lenses are offset by savings due to unrealized spending for eyeglasses and related medical care in the course of time.