Economic costs of cataract surgery using a rigid and a foldable intraocular lens

Optimal delivery of healthcare requires consideration of various costs. A foldable intraocular lens (IOL) is more expensive than an equivalent rigid IOL. However, surgical and post-operative costs may make a foldable IOL economically preferable. We compared the economic costs of cataract surgery plus implantation of a foldable IOL with implantation of a rigid IOL. Prospective audit of the clinical records of 82 pseudophakes; 39 implanted with a rigid IOL and 43 implanted with a foldable IOL by one surgeon. Average follow-up periods were 25 +/- 7 months and 23 +/- 5 months respectively. There was no difference between the two groups for the follow-up period (P = 0.55), number of post-operative complications (P = 0.25) or cost of post-operative visits (P = 0.83). The cost of single-use theatre equipment was greater for the rigid-IOL group (P= 0.0001). The total identified cost per patient was greater for the foldable-IOL group (P = 0.0001). Despite possible technical advantages, implantation of the foldable IOL did not provide an economic benefit, either in the initial cost or in the costs of post-operative care. Over the 2-year period, implanting with the rigid IOL cost, on average, Pound Sterling57 less per patient. Despite this economic difference, a cost-benefit analysis is required, since other factors may be more important.