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24.10.2017 | Original Article | Ausgabe 1/2018 Open Access

Journal of Public Health 1/2018

German claims data analysis to assess impact of different intraocular lenses on posterior capsule opacification and related healthcare costs

Journal of Public Health > Ausgabe 1/2018
Nils Kossack, Christian Schindler, Ines Weinhold, Lennart Hickstein, Moritz Lehne, Jochen Walker, Aljoscha S. Neubauer, Dennis Häckl
Wichtige Hinweise
The original version of this article was revised: Due to the existence of another journal with the same name, the Publisher has added a subtitle, “From Theory to Practice.” Effective as of January 2018, the new title of this Journal is Journal of Public Health: From Theory to Practice.
A correction to this article is available online at https://​doi.​org/​10.​1007/​s10389-017-0893-1.



Cataract extraction is one of the most frequent surgeries in Germany. In most cases, the clouded natural lens is replaced by a hydrophobic or hydrophilic acrylic intraocular lens (IOL) implant. The most common long-term complication after cataract surgery is the development of a posterior capsule opacification (PCO). Although no precise real world data are available, published evidence suggests a lower risk for PCO development for hydrophobic acrylic IOLs compared to hydrophilic acrylic IOLs. Therefore, in the present study we assessed real world data on the impact of different IOL material types on the incidence of post-operative PCO treatment.

Subject and methods

In this retrospective study, we included 3,025 patients who underwent cataract extraction and implantation of either an acrylic hydrophobic or hydrophilic IOL in 2010. We assessed clinical outcomes and direct costs in a 4-year follow-up period after cataract surgery from a statutory health insurance (SHI) perspective in Germany.


PCO that required capsulotomies occurred significantly (p < 0.0001) less frequent in patients who had received a hydrophobic IOL (31.57% of 2,078 patients) compared to the group with hydrophilic IOL implants (56.6% of 947 patients) and costs per patient for postoperative treatment in a 4-year follow-up were 50.03 € vs. 87.81 € (i.e. 75% higher in the latter group, p < 0.0001).


Considering the high prevalence of cataract, the economic burden associated with adverse effects of cataract extraction is of great relevance for the German SHI. Hydrophobic lenses seem to be superior regarding both medical and economic results.

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