OBJECTIVES: Cataract extraction is the most frequent operative procedure worldwide. The clouded natural lens is replaced by an artificial intraocular lens (IOL) implant, in most cases a hydrophobic or hydrophilic acrylic IOL. The most common long-term complication after cataract surgery is the development of a posterior capsule opacifications (PCO), which is usually treated with neodymium-doped yttrium-aluminium-garnet (Nd:YAG) laser. The aim of this study was to assess real world data on the impact of different IOL material types on the incidence of post-operative PCO treatment as well as associated follow-up costs from a Statutory Health Insurance (SHI) perspective in Germany.

METHODS: From a sample of six million SHI members, we included patients who underwent cataract extraction and implantation of either an acrylic hydrophobic or hydrophilic IOL in 2010. We assessed clinical outcomes and compared direct costs in a 4-year follow-up period after cataract surgery.

RESULTS: CONCLUSIONS: Considering the high prevalence of cataract, the economic burden associated with treatment of long-term complications after cataract extraction is of great relevance for the German SHI. Implantation of hydrophobic lenses seems to be superior regarding both medical and economic results.