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Square-edged IOLs produced smaller drop in capsulotomy rate than expected
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Rates of Nd:YAG laser capsulotomies decreased in the United States after square-edged IOLs were introduced, according to a study by researchers in Houston and London. However, the decrease was not as large as had been expected, the study authors noted.
Georgia Cleary, MRCOphth, and colleagues at St. Thomas' Hospital, London, and Cullen Eye Institute, Houston, investigated how the introduction of square-edged IOLs affected laser capsulotomy rates in the United States using Medicare claims data for 1993 through 2003.
The researchers calculated the numbers of implanted square- and round-edged IOLs after obtaining data on square-edged IOL market share. They then compared actual capsulotomy rates with rates predicted by a model, which was based on published postmortem and clinical data, according to the study.
Between 1993 and 2003, the number of Medicare-reimbursed cataract surgeries increased by 67.4% and the number of Medicare-reimbursed Nd:YAG laser capsulotomies increased by 18.9%.
"After the introduction of square-edged IOLs in 1995, the market share grew to 48.5% in 2003," the authors said. However, the total number of 2003 Medicare-reimbursed Nd:YAG capsulotomies was at least 23.9% higher than the number of predicted capsulotomies, they reported.
The discrepancy between the predicted and actual laser capsulotomies generated at least $30 million in additional costs to Medicare in 2003, the authors noted.
The study is published in the November issue of Journal of Cataract & Refractive Surgery.