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OBJECTIVES: Previous studies showed that hydrophilic intraocular lenses (IOLs) have a significantly higher Nd:YAG capsulotomy (Nd:YAG) rate compared to hydrophobic IOLs. This creates an additional burden to the UK healthcare system. Here, the potential environmental impact, Nd:YAG procedure time, and associated costs were compared for hydrophilic and hydrophobic IOL patients.
METHODS: The 2022 NOD audit includes 177,843 procedures completed with hydrophobic IOLs and 197,762 with hydrophilic IOLs. These data were used to calculate carbon emissions, Nd:YAG procedure time, and Nd:YAG related costs associated with IOLs for cataract procedures completed in the UK. The 3-year Nd:YAG rates for hydrophobic and hydrophilic IOLs were 4.2% and 14.9%, respectively. Nd:YAG procedures were 20 minutes long, cost £173, and produced 11.14 kgCO2e per procedure. Additionally, 9.6%, 6.4%, and 0.5% of Nd:YAG cases were assumed to develop ocular hypertension, macular edema, and retinal detachment, costing £106, £313.30, and £1,759, respectively, to treat.
RESULTS: Hydrophilic IOLs required 2.14 minutes of Nd:YAG procedure time, produced 1.19 kgCO2e, and cost £18.51 more per cataract surgery than hydrophobic IOLs at 3-years post-surgery. Hydrophilic IOLs also incurred an additional cost of £4.18 per cataract surgery when compared to hydrophobic IOLs due to ocular hypertension, macular edema, and retinal detachment. Therefore, each hydrophilic IOL costs a total of £22.69 more than hydrophobic IOLs per cataract surgery. If all 375,605 cataract procedures in NOD 2022 were completed using hydrophobic IOLs, then the burden on the UK healthcare system would be reduced by 235,704 kgCO2e in emissions, 423,166 procedure time minutes, and £3,660,389 in procedure costs with an additional £825,644 saved from treating capsulotomy-related complications.
CONCLUSIONS: Hydrophilic IOL PCO related procedures result in substantial economic and environmental burden to the UK healthcare system. Switching to hydrophobic IOLs may reduce costs, free time for alternative procedures, and reduce the environmental impact of cataract surgeries.