OBJECTIVES: Posterior capsule opacification is the most commonly reported complication post cataract surgery, and treated by Nd:YAG laser capsulotomy. PCO could occur due to several factors, most importantly is intraocular lens biomaterial and design factors. Nd:YAG laser capsulotomy is a safe procedure however but some complications including retinal detachment (RD), glaucoma, and cystoid macular edema (CME) have been reported. The present analysis estimated cost impact of Nd:YAG procedures due to AcrySof vs. other single-piece acrylic IOLs in UK.

METHODS: A cost-consequence model compared healthcare resource utilization and costs of different single-piece acrylic IOLs. Cumulative incidence of Nd:YAG capsulotomy procedure at 5 years post-cataract surgery with four single-piece acrylic IOLs was derived from retrospective cohort EMR database study conducted in the US (5.80% for AcrySof, 8.50% for Tecnis, 15.20% for B&L Akreos and 19.30% for Lenstec). Cumulative incidence of post-Nd:YAG complications at 5 years was estimated using published literature: RD (4.10%), glaucoma (14.28%), and CME (26.40%). Costs data were based on published UK HRGs (Nd:YAG: £233.0, Vitrectomy: £1281.0) and literature (glaucoma: £475.0, CME: £69.85). Annual number of cataract surgery estimates were derived from published Eurostat statistics.

RESULTS: For 480,934 cataract procedures carried out in one year, single-piece hydrophobic AcrySof IOLs were found to be associated with significantly lower incidence of Nd:YAG post 5 years of cataract surgery when compared to Tecnis (‑12,985), B&L Akreos (‑45,208) and Lenstec (‑64,926) with subsequent reductions in RD, glaucoma and CME cases. Total cost savings for the UK healthcare system with the use of AcrySof over other IOLs ranged from £4.9 million (vs. Tecnis) to £24.1 million (vs. Lenstec).

CONCLUSIONS: Using single-piece acrylic AcrySof IOL during cataract surgery could substantially offset treatment burden of Nd:YAG and related complications post-cataract surgery, when compared to other single-piece acrylic IOLs.