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First Author: N.Maycock UK
Co Author(s): D. Etchells J. Kersey
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To assess the potential market for toric lenses in a UK district general hospital.
The Royal Bournemouth Hospital, Castle Lane East, Bournemouth, Dorset, BH7 7DW, UK
A retrospective review of all the cataract operations carried out in one hospital between January - December 2012. Demographics, preoperative biometry, refraction and visual acuity were recorded. Astigmatism was calculated as the difference between preoperative K readings (K1-K2) and patients were grouped as follows: 0-0.5D; 0.50-1.0D; 1.0-1.5D; 1.5-2.0D; >2.0D. Data was collected from the local private hospital to assess and compare how many toric / multifocal intraocular lenses were inserted between 2010 - 2012.
Total number of cataract surgeries n=1908. Patients were divided into the following groups based on their astigmatism: 0-0.5D n=423 (22.2%); 0.5-1.0D n=673 (35.3%); 1.0-1.5D n=382 (20.0%); 1.5-2.0D n=213 (11.2%); >2.0D n=217 (11.4%). Cost of Tecnis Toric implant £280. Cost of standard Tecnis 1-piece aspheric intraocular lens implant £60. Cost of implanting toric lens implant in patients with astigmatism >1D = £178,640 (812 eyes at £280 for a Tecnis Toric implant minus £60 cost of standard aspheric lens). In the local private hospital, the number of toric and multifocal lenses implanted has risen steadily since 2010. Toric implants: 2010 n=1; 2011 n=9; 2012 n=36. Multifocal implants: 2010 n=4; 2011 n=12; 2012 n=23.
This study shows there is a large patient population who would benefit from toric lenses who currently do not have access to this technology on the UK public healthcare system (NHS). Patients with a cylinder greater than 1 dioptre, would have improved distance visual acuity, however, this would add £178,640 to the lens budget of one hospital alone. While this is not currently viable it does demonstrate a large cohort of patients who are not receiving the latest in lens technology.