The economic cost of posterior capsule tear at cataract surgery

Purpose To estimate the direct financial burden to healthcare purchasers of a posterior capsule tear (PCT) during cataract surgery.

Methods A retrospective data analysis of cataract surgeries was performed. Patients who had surgery in the 2-year period from April 2005, with a maximum follow-up, to April 2009 were identified. Patients previously under review for ocular comorbidity apart from cataract were excluded. Each case with PCT was matched with an uncomplicated cataract operation performed on the same list by the same grade of surgeon. For both groups, we extracted details of all additional subsequent visits and interventions. Data on the cost of visits and procedures were provided by the Department of Health. We then compared this data between groups.

Results A total of 100 patients with PCT were matched with 100 controls. The preoperative parameters of the two groups were similar. The cases required a median of 3 (mean 3.6, range 0–24) additional postoperative visits compared with 0 (mean 0.19, range 0–8) for controls, with a median duration of follow-up of 74 (mean 129.5, range 6–1316) days for cases compared to 21 (mean 26.1, range 0–308) days for controls (p=0.000). The average cost of extra visits was £475.0 (SD £697.8) for cases and £69.2 (SD £51.0) for controls (p<0.001).

Conclusions Based on the National Health Service national tariff, a PCT during cataract surgery results in significant additional financial cost to healthcare purchasers. A full cost analysis would be required to estimate the additional cost of a PCT for the healthcare provider.