German claims data analysis to assess impact of different intraocular lenses on posterior capsule opacification and related healthcare costs

Kossack, Nils; Schindler, Christian; Weinhold, Ines; Hickstein, Lennart; Lehne, Moritz; Walker, Jochen; Neubauer, Aljoscha S.; Häckl, Dennis

doi:10.1007/s10389-017-0851-y

Cited by 24 publications

(29 citation statements)

References 40 publications

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“…We also found more severe PCOs with hydrophilic IOLs than hydrophobic IOLs. This was agreed with the higher PCO occurrences, PCO scores and Nd:YAG laser surgery rates in previous hydrophilic IOLs related studies [1,15]. This might be due to the surface of hydrophilic IOLs, which was more suitable for migration and proliferation of LECs [23].…”

Section: Discussionsupporting

confidence: 90%

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AS-OCT application in quantifying Posterior capsule opacification severity with varied IOL designs

Yu¹,

Lu²,

Guo³

et al. 2020

Preprint

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Background To evaluate application of AS-OCT in PCO severity assessment and analyse relationship between PCO severity and IOL characters. Methods PCO patients were prospectively recruited. Cross-sectional images of the anterior segment at horizontal and vertical medians were acquired with AS-OCT. The area of the IOL-PC (posterior capsular) space and PCO severity (area, thickness and density at 3 mm and 5 mm IOL optic regions) were measured. The relationship between visual acuity and PCO severity, comparisons of PCO severity and IOL-PC space using varied IOL designs were analysed. Results One hundred PCO eyes were enrolled. IOL-PC space and PCO thickness and area was positively correlated with axial length. The cut-off level of visual acuity: was 0.52 Log MAR. Visual acuity were positively correlated with PCO area and thickness when visual acuity was ≤ 0.52 Log MAR. 3-piece C haptic IOL showed a smaller PCO area and thickness than the 1-piece 3 haptic IOL and 1-piece 4 haptic IOL. PCO area and thickness values for an IOL with a diameter ≤ 11.0 mm were greater than for an IOL with a diameter of 12.5 mm. The differences were statistically significant. PCO area and thickness increased when IOL haptic angulation increased (from 0 to 12 degrees). Conclusions In PCO eyes, cut-off level of visual acuity was 0.52 Log MAR. With more severe PCO, visual acuity maybe not enough to describe the visual function impairment. PCO severity and IOL-PC space was significantly correlated with axial length and IOL design and material.

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Section: Discussionsupporting

confidence: 90%

“…PCO is a major long-term complication of cataract surgery, which normally occurs at several weeks to years after removal of the cloudy lens. The prevalence of PCO is 4.1% at 1 year and 22.8%-38.5% at 2-4 years [1]. PCO leads to a decrease in visual acuity, contrast sensitivity and objective visual quality.…”

Section: Introductionmentioning

confidence: 99%

AS-OCT application in quantifying Posterior capsule opacification severity with varied IOL designs

Yu¹,

Lu²,

Guo³

et al. 2020

Preprint

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“…Neodymium-doped yttrium aluminium garnet (Nd:YAG) laser capsulotomy is the only effective surgical treatment for PCO [4], and is a routine and largely safe procedure, but could be associated with occasional complications that include elevated intraocular pressure, retinal detachment, and endophthalmitis [4][5][6]. The requirement to perform Nd: YAG capsulotomies as a consequence of PCO places a considerable financial burden on healthcare systems.…”

Section: Introductionmentioning

confidence: 99%

5 year incidence of YAG capsulotomy and PCO after cataract surgery with single-piece monofocal intraocular lenses: a real-world evidence study of 20,763 eyes

Ursell

Dhariwal

O'Boyle

et al. 2019

Eye

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Objectives To evaluate the 3-and 5-year incidence of posterior capsule opacification (PCO) and neodymium-doped yttrium aluminium garnet (Nd:YAG) capsulotomy in patients following cataract surgery, comparing results for different single-piece acrylic hydrophilic and hydrophobic monofocal intraocular lens (IOL) models and other patient factors. Patients and methods Electronic medical record data collected from seven United Kingdom (UK) National Health Service (NHS) ophthalmology clinics for routine, age-related (≥65 years) cataract surgeries that implanted single-piece acrylic monofocal IOLs during 2010-2013 were used to calculate 3-and 5-year incidence of Nd:YAG and PCO. IOL models of Alcon Acrysof, AMO Tecnis, Bausch & Lomb (B & L) Akreos, LenStec Softec, and Rayner Flex were analyzed. Pairwise comparisons were conducted between AcrySof IOLs and other IOLs using Bonferroni adjustment for multiplicity. Multivariate analyses were conducted adjusting for known confounders. Results The incidence of Nd:YAG capsulotomy ranged between 2.4-12.6% at 3 years and 5.8-19.3% at 5 years postcataract surgery. Similarly, the incidence of PCO ranged between 4.7-18.6% at 3 years and 7.1-22.6% at 5 years. When comparing all of the single-piece IOLs, AcrySof demonstrated the lowest incidence rates for both PCO and Nd:YAG (P < 0.001 for each comparison). From adjusted logistic regression analysis, AcrySof were associated with lower 3-and 5-year odds of Nd:YAG and PCO incidence. Conclusions Following cataract surgery with single-piece monofocal IOLs different incidence rates of PCO were observed with different IOLs. AcrySof IOLs were associated with significantly lower incidence of PCO requiring Nd:YAG treatment over periods of 3 and 5 years.

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“…В другом зарубежном ретроспективном исследовании N. Kossack и соавт. [25] проводилась оценка частоты развития вторичной катаракты в зависимости от свойств материала имплантированной ИОЛ. В ходе исследования было показано, что при использовании гидрофобных ИОЛ значительно реже развивается вторичная катаракта -в 31,57 % случаев по сравнению с 56,6 % при применении гидрофильных ИОЛ (p < 0,0001).…”

Section: -й вариантunclassified

“…Таким образом, в ряде зарубежных исследований [24,25] и в настоящем клинико-экономическом анализе было показано, что применение гидрофобных ИОЛ, в частности ИОЛ на платформе AcrySof®, ассоциировано с более низкой частотой развития вторичной катаракты и, соответственно, с меньшими затратами на лечение осложнений. выводы В представленном исследовании была проведена оценка клинической эффективности и экономической целесообразности применения различных моделей монофокальных ИОЛ.…”

Section: -й вариантunclassified

Pharmacoeconomic Analysis of Using Different Types of Monofocal Intraocular Lenses for Cataract Surgery in Russia

2019

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Purpose: To perform cost-effectiveness analysis of using different types of monofocal intraocular lenses (IOL) for cataract surgery in adults in Russian Federation. Materials and methods. MS Excel based model of medical care patients with cataract has been developed for 1 patient undergoing surgery treatment. “cost-effectiveness” and “budget impact” analyses (BIA) were used to measure the costs associated with cataract treatment with different types of monofocal IOLs for the state budget. Direct medical costs included IOLs cost, treatment of PCO with neodymium-doped uttrium aluminium garnet laser capsulotomy (Nd:YAG), side effects treatment associated with Nd:YAG and were calculated from the Russian healthcare system perspective. Results. Cost-effectiveness analysis among monofocal IOLs demonstrated that the lowest costs for 1 case of successful cataract surgery followed by implantation of the IOL are connected with the use of the AcrySof® Single Piece model — 4,938 rubles, the largest costs — using the Tecnis® One model — 11,753.5 rubles. The use of others hydrophobic IOLs on the AcrySof® platform demonstrated economic feasibility, analyzed models have costs for 1 effective cataract treatment -AcrySof® IQ 9,858 rubles, AcrySof® Natural 6,452 rubles. The conducted BIA has showed that direct medical costs for surgical treatment of cataracts with the implantation of monofocal IOLs from different manufacturers for 100 patients amount to 708,121 rubles. If ua monofocal IOL are used alone on an AcrySof® platform, the cost will be 691,261 rubles, the difference is in favor of monofocal IOL on an AcrySof® platform — 16,860 rubles. Conclusion. Using AcrySof® IOLs for cataract surgery in adult patients is an effective and an economically justified treatment option in Russia Federation.

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German claims data analysis to assess impact of different intraocular lenses on posterior capsule opacification and related healthcare costs

Cited by 24 publications

References 40 publications

AS-OCT application in quantifying Posterior capsule opacification severity with varied IOL designs

AS-OCT application in quantifying Posterior capsule opacification severity with varied IOL designs

5 year incidence of YAG capsulotomy and PCO after cataract surgery with single-piece monofocal intraocular lenses: a real-world evidence study of 20,763 eyes

Pharmacoeconomic Analysis of Using Different Types of Monofocal Intraocular Lenses for Cataract Surgery in Russia

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