Abstract
Posterior Capsular Opacification (PCO) is a key secondary complication of IOL implant following cataract surgery and clinically significant PCO requires Nd: YAG laser capsulotomy treatment which in turn could lead to further complications. The objective of this analysis was to develop a cost-consequence model to estimate the healthcare resource utilization and cost impact of YAG procedures due to different single-piece acrylic IOLs. A cost-consequence model from Italian national healthcare system perspective was developed. For input parameters, three year incidence of Nd:YAG laser capsulotomy for five single-piece acrylic IOL s (2.4% for AcrySof, 5.1% for Tecnis, 9.2% for Akreos, 12.3% for Lenstec and 12.6% for Rayner) were derived from a retrospective electronic medical records database study. Weighted average calculations were performed to derive 3 year post-YAG incidence of retinal detachment (4.4%), glaucoma (8.8%), and cystoid macular edema (16.9%) using published data. National average of published YAG (€95.4) and Vitrectomy (€1641) DRG tariffs were used, and glaucoma (€522) and CME treatment costs (€79.8) were sourced from the literature. Number of cataract procedures per annum was derived from Eurostat statistics. For 526,966 cataract procedures carried out in a year, in 3-years post cataract surgery, single-piece hydrophobic AcrySof IOLs could result in substantially fewer Nd:YAG procedures compared to Tecnis (n=14,228), B&L Akreos (n=35,834), Lenstec (n=52,170) and Rayner (n=53,751) IOLs with subsequent reductions in vitrectomy, glaucoma and CME treatments. Total cost savings for the Italian healthcare system due to AcrySof IOLs could be in the range of €3.2 to €12.2 million. These results suggest that single-piece hydrophobic AcrySof IOLs are associated with significantly lower incidence of Nd:YAG capsulotomy compared to comparator IOLs resulting in significant reduction in healthcare resource utilization for facilities and cost savings for budget owners.
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