Document Detail

Effect of square-edged intraocular lenses on neodymium:YAG laser capsulotomy rates in the United States.
MedLine Citation:
PMID:  17964395     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To model the effect of the introduction of square-edged intraocular lenses (IOLs) in the United States on neodymium:YAG (Nd:YAG) laser capsulotomy rates and to compare the model with actual capsulotomy rates. SETTING: Ophthalmology Department, St. Thomas' Hospital, London, United Kingdom, and Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA. METHODS: The actual numbers of cataract surgeries and Nd:YAG laser capsulotomies performed in the U.S. were obtained from Medicare claims data for 1993 to 2003. The percentage market share of square-edged IOLs was obtained, and numbers of square-edged and round-edged IOLs implanted were calculated. Predicted laser capsulotomy rates were modeled on published postmortem and clinical data and compared with actual capsulotomy rates. RESULTS: Between 1993 and 2003, the number of cataract surgeries and Nd:YAG laser capsulotomies reimbursed by Medicare rose by 67.4% and 18.9%, respectively. After the introduction of square-edged IOLs in 1995, the market share grew to 48.5% in 2003. The total number of Nd:YAG capsulotomies reimbursed by Medicare in 2003 exceeded the number of capsulotomies predicted by the model by at least 23.9%. The estimated cost generated by the discrepancy between predicted and actual laser capsulotomies in 2003 was at least US $30 million. CONCLUSIONS: After the introduction of square-edged IOLs, Nd:YAG laser capsulotomy rates decreased, but not by as much as predicted. The additional cost to the Medicare system was more than US $30 million higher than the model predicted.
Georgia Cleary; David J Spalton; Douglas D Koch
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cataract and refractive surgery     Volume:  33     ISSN:  0886-3350     ISO Abbreviation:  J Cataract Refract Surg     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-29     Completed Date:  2007-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8604171     Medline TA:  J Cataract Refract Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1899-906     Citation Subset:  IM    
Ophthalmology Department, St. Thomas' Hospital, London, United Kingdom.
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MeSH Terms
Cataract / therapy
Cataract Extraction / statistics & numerical data*
Insurance Claim Reporting / statistics & numerical data
Laser Therapy / statistics & numerical data*
Lens Capsule, Crystalline / surgery*
Lens Implantation, Intraocular
Lenses, Intraocular*
Medicare / statistics & numerical data*
Postoperative Complications*
Prosthesis Design
United States / epidemiology
Reg. No./Substance:
0/Acrylates; 79-10-7/acrylic acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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