OBJECTIVES: To compare the lifetime costs of complications due to posterior capsule opacification after cataract surgery in three types of IOLs, namely two hydrophobic lenses SA60AT, AR40E and one hydrophilic lens the XL-Stabi. METHODS: Costs were estimated from the results of a retrospective study of patients who underwent cataract surgery in 2001 and 2002 as well as from data in the literature. Data were analysed after a minimum of 3 years post-surgery using Kaplan-Meier survival curve analysis with the end event being time to Nd:Yag laser capsulotomy. Costs were calculated using two methods of extrapolation. The economic perspective was that of the French Sickness Fund. RESULTS: After 3 years of follow-up, the percentage of patients who had undergone Nd:Yag laser capsulotomy was 12.0% with the SA60AT, 25.2% with the AR40E and 51.0% with the XL-Stabi lenses (P<0.001). The total cost of capsulotomy and management of complications per patient lifetime was estimated to be 142.6 Euros for SA60AT, 273.4 Euros for AR40E ad 347.1 Euros for XL-Stabi using the first method of extrapolation, while using the second method of extrapolation, the costs were 242.8, 317.6 and 347.2 Euros, respectively. CONCLUSION: Lower costs for cataract surgery and management of related complications were observed with the SA60AT and AR40E IOL's with the lowest overall costs being observed in the SA60AT lens.