Current opinion in ophthalmology · 2025
Impact of insurance status on toric premium intraocular lens selection for patients undergoing cataract surgery with astigmatism.
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Ashby Conrad K, Sitto Mina M, Sant David W, Moshirfar Majid
Аннотация
PURPOSE OF REVIEW: To evaluate the association between insurance status and the selection of toric premium intraocular lenses (IOLs) among patients undergoing cataract surgery with astigmatism.
RECENT FINDINGS: In this retrospective study of 4525 patients (7299 eyes), 71.3% of eyes received conventional IOLs, and 28.7% received premium IOLs, of which 34.8% were toric lenses. Logistic regression with adjustment for age, sex, and surgeon was used to assess associations between insurance status and IOL selection. Patients with commercial insurance were significantly more likely to select toric IOLs (14%) than those with Medicare (9.2%, P < 0.001) and Medicare Advantage (7.6%, P < 0.001). Among eyes with moderate-to-severe astigmatism (≥1.5 D), 40.7% were estimated to be eligible for toric correction, yet only 24.5% received a toric IOL.
SUMMARY: Insurance status significantly influences toric IOL selection, with lower utilization observed among patients with Medicare and Medicare Advantage. Many patients deemed eligible for toric correction did not receive a toric IOL, suggesting underutilization likely driven by cost and insurance coverage limitations. With astigmatic correction becoming more common in cataract surgery, policy discussions should balance clinical efficacy and affordability of toric IOLs to improve access and visual outcomes.
RECENT FINDINGS: In this retrospective study of 4525 patients (7299 eyes), 71.3% of eyes received conventional IOLs, and 28.7% received premium IOLs, of which 34.8% were toric lenses. Logistic regression with adjustment for age, sex, and surgeon was used to assess associations between insurance status and IOL selection. Patients with commercial insurance were significantly more likely to select toric IOLs (14%) than those with Medicare (9.2%, P < 0.001) and Medicare Advantage (7.6%, P < 0.001). Among eyes with moderate-to-severe astigmatism (≥1.5 D), 40.7% were estimated to be eligible for toric correction, yet only 24.5% received a toric IOL.
SUMMARY: Insurance status significantly influences toric IOL selection, with lower utilization observed among patients with Medicare and Medicare Advantage. Many patients deemed eligible for toric correction did not receive a toric IOL, suggesting underutilization likely driven by cost and insurance coverage limitations. With astigmatic correction becoming more common in cataract surgery, policy discussions should balance clinical efficacy and affordability of toric IOLs to improve access and visual outcomes.