Expert Ophthalmologist comments on increased demand for cataract surgery

A recent study reveals the increasing demand for cataract surgery, raising the need to manage costs and ensure access to appropriate cataract treatment.

The study was carried out in the USA and published in the Journal of Cataract & Refractive Surgery. It found that more people are getting the vision-improving procedure, seeking it at younger ages and having both eyes repaired within a few months, rather than only treating one eye.

"Cataract surgery rates are rising in all age groups between 50 and 90, but the greatest increase is in the 70- and 80-year-olds. And part of that is that our older population, or the aging baby boomers, are working longer, they want to be more active, they have more demands on their vision.That's why they're looking for surgery sooner -- so that they can remain independent, remain active and continue to work” says senior author Dr Jay Erie, a Mayo Clinic ophthalmologist.

Cataracts can blur vision and worsen glare from lights. They can make it difficult to drive safely, perform household tasks and maintain a normal level of independence. In cataract surgery, the eye lens is removed and usually replaced with an artificial lens, without requiring a hospital stay. In the United States, age-related cataracts affect at least 22 million people and cost an estimated $6.8 billion to treat each year; the cataract caseload is expected to rise to 30 million people by 2020, the researchers noted.

The research found:

·         Cataract surgery has increased steadily, peaking in 2011 at a rate of 1,100 per 100,000 people.

·         Sixty per cent of people receiving cataract surgery on one eye returned within three months to have it performed on the second eye, a significant increase over the number in a previous Mayo study, which covered 1998 to 2004.

·         The mean annual rate of cataract surgery for women was significantly higher than for men.

·         There were significant increases in cataract surgery over the past 32 years among people in all age groups, except those 90 and older.

Dr Erie says that the trend raises questions about treatment costs and the resources needed to meet demand. "Ophthalmology and ophthalmologists and patients and payers are beginning to look at ways they can weigh the visual benefits to the individual patient against the cost to society as a whole … how can we maximise the outcome and minimise the cost to society?" Dr. Erie says.

Professor Charles Claoué, comments: “The success of modern cataract surgery means that people now only need minimal cataract to benefit from treatment, notably with the introduction of multifocal, toric, and toric-multifocal intraocular lenses. This has led to many people not waiting for cataracts to develop before having what is called “Refractive Lens Exchange” which is a very similar procedure undertaken to reduce or abolish the need to wear spectacles. Many of the “Baby Boomer” generation have already had Laser Vision Correction in young adulthood, and are not happy at the idea of needing reading glasses at the age of 50. These individuals seek treatment rather than wait for cataract development making treatment unavoidable. Of course, one advantage of a refractive lens exchange is that the patient will never develop cataract, which minimises costs to society since refractive lens exchange is typically self-funded whereas cataract surgery is state-funded.”

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