POSA291 Impact of Intrepid® Hybrid Tip on Incidence and Cost of Posterior Capsule Ruptures in Cataract Surgery

Abstract

The Intrepid® Hybrid tip has a rounded polymer edge designed to decrease the risk of posterior capsule ruptures (PCRs) during cataract surgery. The purpose of this study was to compare PCR rates and the subsequent PCR management costs with the Intrepid Hybrid tip and metal tips. A decision analytic model from the health care provider’s perspective was developed in Excel for a hypothetical cohort of 1,000 cataract surgery patients. The model inputs were informed by targeted literature reviews. PubMed was searched for clinical or experimental studies published since 2010 using terms such as “Intrepid Hybrid tip”, “phacoemulsification or cataract surgery”, and “posterior capsule rupture”. Studies were included if they reported PCR rates (overall or resident-specific) or associated resource use, or if they used the Intrepid Hybrid tip. The model calculated direct (surgical and postoperative management of PCRs) and indirect (loss of revenue due to PCR and fewer referrals) costs in 2019 USD. PCRs occur in 0.60%-2.39% of all cataract surgeries (n=5 studies) and 0.8%-13.0% of resident-performed surgeries (n=8 studies). Each PCR requires 3 additional follow-up visits (n=3 studies) and 10%-69% of PCRs result in vitrectomy (n=3 studies). The Intrepid Hybrid tip was estimated to reduce the incidence of PCR by up to 4x when compared to metal tips based on the torsional power required before PCR upon contact with the capsule in an experimental study. Therefore, the Intrepid Hybrid tip may decrease PCR rates to 0.15%-0.60% for cataract surgery overall, saving health care providers up to $46,634 per 1,000 cases. For resident-performed surgery, the PCR rate may decrease to 0.2%-3.25%, saving up to $121,368 per 1,000 cases. Using the Intrepid Hybrid tip instead of a metal tip during cataract surgeries may help to reduce PCR rates, health care resource use, and costs to health care providers.