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Patient costs for supplies higher for contact lens correction in Infant Aphakia Treatment Study
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The combined cost of supplies for contact lens correction paired with cataract surgery can be more expensive for the family over 5 years compared with IOL implantation during unilateral cataract surgery, according to a study.
The retrospective cost analysis of the Infant Aphakia Treatment Study compared the treatments of 114 infants who underwent unilateral cataract surgery using either primary IOL implantation during the procedure or contact lens correction postoperatively. The study examined the mean costs of cataract surgery and additional surgeries, examinations and supplies used over 5 years, based on Georgia Medicaid reimbursement.
The 5-year cost per patient for the IOL implant was $27,090, while the cost for contact lens correction was $25,331. The mean cost of cataract surgery using an IOL implant was 6.9% more expensive than contact lens correction.
However, due to the cost and number of lenses required annually, supplies totaled $7,728 per patient in the contact lens group, while supplies cost $3,204 per patient in the IOL implant group. Supply costs were approximately 2.5 times more expensive in infants treated with contact lens correction after surgery vs. those treated with IOL implants. – by Kristie L. Kahl
Disclosure: The authors report no relevant financial disclosures.
Perspective
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Lisa Brothers Arbisser, MD
Economic consequences of treatment options in addition to the medical risk and benefit must be included with informed consent. Particularly when, as this study showed, the visual results of infants treated with IOL implantation at the time of initial cataract surgery was equivalent to those left aphakic with contact lens (CL) rehabilitation. Ultimately, due to needed subsequent surgery mainly for visual axis obscuration in the implanted group, there was about a 7% increase in cost over CL corrected aphakic patients. The cost to families however was over twice as much for aphakic patients over 5 years.
Outside of a clinical study, where costs of CLs may be entirely out of pocket, the inability to manage this burden may permanently adversely affect visual outcome due to periods of uncorrected aphakia worsening amblyopia. This issue must be carefully considered when counseling families of infants with congenital cataract.
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