Recommendation ID

Toric lenses for astigmatism:- What is the cost effectiveness of toric lenses compared with on-axis or limbal-relaxing incision surgery, or non-toric lenses with no further intervention, in an NHS context, taking account of the whole care pathway cost implications from pre- to postoperative phases, stratified by the preoperative level of astigmatism?

Any explanatory notes
(if applicable)

Why this is important:- There is clear evidence that toric lenses are effective at reducing levels of postoperative astigmatism, but evidence on their cost effectiveness is much less conclusive. Although a cost–utility analysis of toric lenses was evidenced from the USA, it was not possible to relate the costs to a UK NHS perspective. Acquisition costs of toric lenses are unlikely to exceed those of standard monofocal lenses, but their use has possible associated costs, including additional preoperative tests, biometry measurements, surgical time and equipment (toric markers), postoperative assessments and further surgery, which could be significant. A comparison with
on-axis or limbal-relaxing incisions would be advantageous because there are currently no resource constraints for using these techniques. Further cost-effectiveness research using UK NHS costings would be of benefit in helping to formulate future recommendations about their use.

Source guidance details

Comes from guidance
Cataracts in adults: management
Date issued
October 2017

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 31/10/2017