As we can read in "Health at a Glance: Europe 2012", cataract surgeries are becoming the most popular surgical procedure in many European countries. The UE society is getting older, which significantly impacts the growth of affected people.
The number of people suffering from eye conditions continues to grow. WHO (World Health Organization) analysts say that if the growth persists at the same level, by 2020 even 75 million people can lose sight completely. According to the statistics of WHO cataract takes the first place in the ranking of conditions that cause blindness. It is confirmed by PBA (Prevent Blindness America) - their specialists claim that 22 million Americans of 40 years old and more are affected by the condition, and since the society is getting older, it is predicted that by 2020 over 30 million patients will suffer from cataracts. According to PBA surveys, cataract surgery is one of the most common eye procedures carried out in the United States - every year over 3 million Americans undergo the treatment. The situation in Poland is similar - Dr Piotr Jurowski, MD, PhD, from the Military Teaching Hospital in Łódź, says that one in fifty people are suffering from cataract. It is estimated that circa 800 thousand Poles are affected (according to the data of the Military Teaching Hospital in Łódź), but for a variety of reasons, much fewer of them undergo the treatment.
Cataract is a painless eye disease. The condition can be congenital (it is already recognized in newborns), or acquired, including age-related, traumatic or secondary (clouding of the capsule left after lens removal). It is treated by performing a laser hole in the capsule, i.e. YAG-capsulotomy.) It relates to older people mostly, however it increasingly emerges in younger age groups (30-40 yr olds). Metabolic disorders, exposure to X-ray radiation or steroid treatments can be the cause of the condition. Its main symptom is the progressive clouding of an eye lens, which in consequence causes sight deterioration. People suffering from the condition are most frequently complaining of clouded vision, sometimes problems in colour vision and light refraction. Untreated cataract progresses with time, and vision becomes increasingly deteriorated. The disease can be caused by diabetes, trauma or chronic inflammation inside the eye, however for the age-related cataract no clear causes have been determined as of now. Therefore, according to Professor Jerzy Szaflik, the only safe treatment option is a surgical removal of the cloudy lens.
Cataract treatment methods
A commonly used method is phacoemulsification, enabling operation in each stage of the disease. It is an outpatient procedure performed in topical anaesthesia - by administering anaesthetic drops in the conjuctival sac. The patients can leave the clinic after a few hours. Surgery involves the removal of clouded lens with the use of ultrasounds and implantation of an artificial lens (intraocular lens implant). During the procedure, a surgeon performs a small (about 2 mm) incision in the cornea and inserts phacoemulsificator into the eye. Using the tool, he breaks the cloudy lens, and then removes it. Another step is the implantation of the folded artificial lens with the use of a special applicator. The lens will then expand in the pupil.
The ultrasound phacoemulsification is the most popular procedure, however the distorted lens can also be broken down with a stream of liquid in the so-called liquid emulsification. This method is recommended for people suffering from mild cataracts (initial stage). Another version of the method is torsional phacoemulsification, involving microincisions and inserting a special OZiL head into the eye, which, by moving in different directions breaks the lens with a minimal use of ultrasound energy. The technique is applied for operating mature cataracts (hard), in later stages of the disease. To eliminate significant aberrations you can undergo a surgery to remove a clear lens and replace it with an implant of appropriate intensity.
The latest technique used for cataract operations is femtophacoemulsification, which applies femtosecond laser to separate distorted lens from remaining tissues and subsequently break it down. Next, the surgeon removes the rest of the lens and replaces it with a foldable artificial one.
Phacoemulsification in the Polish eye-clinics
Polish patients can choose from a variety of specialist clinics treating eye conditions. Cataract procedures are offered by LEXUM Eye Centre in Warsaw (other branches of the clinic are located in Wrocław, Szczecin, Poznań and Kraków). Elimination of cataracts by the method of phacoemulsification with standard lens implantation will cost PLN 3500. Patients who will decide on a toric lens will need to pay PLN 5000, a pseudoaccommodating one costs PLN 6000, and the pseudoaccommodating toric will come up to PLN 8000. Another facility located in Warsaw, which offers cataract surgeries is Mavit Medical Centre. Treatments are performed by Dr Marek Rękas (Professor). The cost of operating the sublaxated lens cataract with the use of Cionni ring is PLN 6250, phacoemulsification with a standard foldable IOL implant is about PLN 3400, and implantation of the pseudoaccommodating Acrysof ReSTOR TORIC lens instead of a foldable lens will incur a cost of an additional PLN 4800.
If you decide on a procedure at Wrocławskie Centrum Okulistyczne the cost of treatment will be slightly higher. Phacoemulsification with the implantation of a foldable lens performed by Dr Jolanta Markuszewska-Żelbromska, MD, PhD will cost PLN 4100. If you wish to replace a regular foldable lens with IQ IOL you will need to pay PLN 4900. In Weiss Klinik in Chorzów, the cost of phacoemulsification with the implantation of a spherical lens is PLN 3095, the implantation of a toric lens is PLN 4395, cataract surgery with a multifocal lens implantation is PLN 4595, and the insertion of a multifocal lens is around PLN 6900.
Cataract surgeries in Warsaw
Patients can also undergo another procedure called femtophacoemulsification The procedure was introduced byProfessor Jerzy Szaflik from the Warsaw Laser Eye Microsurgery Centre (Centrum Mikrochirurgii Oka) in 2012, as the first specialist in Poland and one of the first in Europe to apply this technique. Today, the surgery at his clinic costs PLN 6200. Professor Szaflik also performs phacoemulsification cataract procedures with the implantation of a foldable UV lens for PLN 4000.
The cost of cataract surgeries abroad
It seems that the cost of a cataract surgery is very high, especially if you are thinking about pseudoaccommodating or toric lens implantations. However, if you compare the cost of the same operations abroad, it is clear that the prices of Polish specialists are much more competitive. According to Clinic Compare, the prices of cataract surgeries in British clinics range between £1800 and £3000 (circa PLN 8660 -14400). For example at the Optegra's Surrey Eye Hospital in Guildford (south-east London) the phacoemulsification procedure is about £2,495 (approximately PLN 12 000). According to worldclassic.com, an average cost of the procedure in the USA ranges between $3000 and 5000 (circa PLN 9500-16000). At the Pacific Medical Centers Ambulatory Surgical Center in Seattle, cataract surgeries cost $4300 (about PLN 13 700), and the same price is expected at the Kemp Surgery Center (Everett).
German Medicine Net website says that the surgery prices in Germany range between €1300 and 1750 (PLN 5400-7300). In Czech Republic, though, prices are much more competitive - Dr Vladimír Korda (Oční clinic in Pardubice) performs cataract surgeries for Kč 500, i.e. about PLN 1700, however multifocal lens implantation will add Kč 18 000 (around PLN 2920) to the cost.
Medical tourism includes ophthalmology
According to Shelter Offshore sources cataract surgery costs in Great Britain are on average around £2,350 (circa PLN 11300). Website's analysts claim that if a British national undergoes an operation in the Czech Republic, they will on average pay about £526, and therefore save 78% off the British price. If, on the other hand, they will decide on a surgery in Bulgaria, the costs will close in £438, equal to 81% in savings. These calculations clearly show why medical tourist migration for cataract surgeries is on the increase. For this reason, one of the very popular countries among British, Germans, Scandinavians as well as Americans is Poland - a place to find expert doctors and state-of-the-art clinics offering procedures with the latest medical equipment.
We already enjoy many foreigners at our clinics, and what is more, owing to the EU directive on cross-border medical treatment, many more will come, as getting medical services abroad will become even simpler. The project applies to key issues for patients, such as reimbursement for medical expenses and regulations on obtaining permits for medical treatment, if applicable. European Parliament and Council Directive (2011/24/UE) dated 9, March enters into force in 2013