Toric and mulitifocal lens utilization independent of patient cost and physician remuneration at a single institution

PURPOSE: To determine if the rates of toric and multifocal intraocular lenses (IOLs) are affected by patient cost or physician reimbursement. METHODS: At Naval Medical Center San Diego (NMCSD) there is no increased patient cost or physician reimbursement for toric or multifocal IOLs. The medical records of all patients who underwent cataract surgery with IOL implantation at NMCSD between 2013 and September 2016 were reviewed. The type of IOL implanted was identified. The rates of toric and multifocal IOL usage were compared to the rates reported in the 2016 American Society of Cataract and Refractive Surgery (ASCRS) Clinical Survey. RESULTS: The inclusion criterion was met for 2585 cataract surgeries. The percentage of toric IOLs at NMCSD in 2016 was 10%. If the patients that received 3 piece or anterior chamber IOLs were excluded, the percentage of single piece IOLs that were toric was 12%. The percentage of multifocal IOLs at NMCSD ranged from 0.8% in 2013 to 0.3% in 2016. The rates of toric and multifocal IOLs reported in the ASCRS clinical survey were 10% and 9%, respectively. CONCLUSIONS AND IMPORTANCE: The rate of toric IOLs usage was not significantly affected by patient cost or physician reimbursement. The rate of multifocal IOLs usage was significantly lower at NMCSD.