title: Economic considerations related to choice of intraocular lens (IOL) and posterior capsule opacification frequency - a comparison of three different IOLs.
abstract: OBJECTIVE
  To evaluate the posterior capsule opacification (PCO) rates in three different modern standard intraocular lenses (IOL) and analyse the related cost.
  
  
  METHODS
  Retrospective study of medical records from 1527 patients who underwent uneventful cataract surgery by phacoemulsification with posterior chamber implantation of either AcrySof SN60 (n = 375), Akreos Adapt (n = 350) or Tecnis Acryl IOL (n = 801). All surgeries were performed by the same surgeon using the same surgical technique and equipment. Primary end-point was neodymium:yttrium-aluminium-garnet (Nd:YAG) capsulotomy for visual impairment secondary to PCO. Cost of IOL material and Nd:YAG capsulotomy for PCO was then evaluated and compared between the IOLs.
  
  
  RESULTS
  Mean follow-up was 41.5 months, and the only statistically significant variable of developing PCO was IOL type and individual follow-up time. Nd:YAG capsulotomy was performed in 7.47% in the AcrySof group, 17.71% in the Akreos group and 3.75% in the Tecnis group. Average cost for Nd:YAG capsulotomy per surgery was €18.75 in the AcrySof SN60 group, €44.25 in the Akreos Adapt group and €9.25 in the Tecnis Acryl group. The combined cost of cataract surgery and PCO treatment was €9.81 higher in for the Akreos Adapt group than the other two combined.
  
  
  CONCLUSIONS
  This retrospective study shows that the risk of PCO and Nd:YAG capsulotomy is significantly higher in hydrophilic Akreos IOL compared with both AcrySof and Tecnis hydrophobic IOLs. The increased risk of PCO in the hydrophilic IOL is related to higher total average costs for cataract surgery.
authors.affiliation: Department of Ophthalmology, Blekinge Hospital, Karlskrona, SwedenDepartment of Ophthalmology, Sahlgrenska Academy, University of Gothenburg, Mölndal, SwedenDepartment of Clinical Sciences, Ophthalmology, Faculty of Medicine, Lund University, Lund, Sweden.
authors.forename: Felix
authors.initials: F
authors.lastname: Cullin
authors.forename: Tobias
authors.initials: T
authors.lastname: Busch
authors.forename: Mats
authors.initials: M
authors.lastname: Lundström
mesh_terms: D000368:Aged; D058442:Capsule Opacification / Q000453:epidemiology* / Q000601:surgery; D004470:Economics, Medical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D019654:Lens Implantation, Intraocular / Q000191:economics; D007910:Lenses, Intraocular / Q000191:economics*; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000191:economics*; D064727:Posterior Capsulotomy / Q000191:economics*; D011474:Prosthesis Design; D012189:Retrospective Studies; D014786:Vision Disorders / Q000191:economics* / Q000534:rehabilitation
keywords: Cataract; cost; economic analysis; healthcare economics; hydrophilic intraocular lens; neodymium:yttrium-aluminium-garnet capsulotomy; posterior capsule opacification