The problem is the prices that surgeons are charging their patients. Some prices are outrageously high and there is great variability between what different surgeons will charge for the same lens. It's difficult for patients to shop around because you can't just walk into a store and read the price tag. Moreover, surgery centers will often not tell you the price over the phone.
When a patient is faced with the authority of a surgeon in the exam room, it can be intimidating and difficult to question the surgeon's recommendation to buy premium lenses or to question the price being charged.
A recent study published in the journal PLoS ONE examined this issue. The researchers posed as patients and telephoned every cataract surgeon in Ontario, Canada, and asked their price for the most common type of specialty intra-ocular lens. They then measured the total prices quoted and price variation between surgeons.
The study concluded that although cataract surgery is covered by public health insurance, some eye surgeons charge much more than others for the same intra-ocular lens and associated testing. The researchers urged that greater access to price information and better regulatory control could help ensure that patients receive fair value for out-of-pocket health expenses.
In British Columbia pricing by surgeons was such a concern that the provincial government took over the market for intra-ocular lenses, using its buying power to get a good deal on the lenses and then to provide them to the public at cost. You can read the press release from the ministry of health here.
Often the best and most objective advice about specialty cataract surgery lenses comes from your optometrist. As eye doctors, they have the knowledge and experience to give you sound advice and because they are not the ones earning fees form doing the surgery or selling the lenses, they have no financial conflict of interest in helping you make the best choice.