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The economics of femtosecond laser-assisted cataract surgery

Bartlett, John D.; Miller, Kevin M.

Current Opinion in Ophthalmology: January 2016 - Volume 27 - Issue 1 - p 76–81
doi: 10.1097/ICU.0000000000000219

Purpose of review Femtosecond lasers for use during cataract surgery carry significant purchase and use costs. The aim of this article is to help surgeons and surgery centers anticipate financial issues related to implementing femtosecond laser-assisted cataract surgery (FLACS). Such scenarios hopefully can help to inform decision making around the purchase and use of these lasers.

Recent findings FLACS has several potential advantages over traditional phacoemulsification. However, although studies have demonstrated noninferiority of FLACS, there continues to be few data to support significantly improved visual outcomes. The literature does show a significantly higher cost for FLACS. As this cost can be passed on to patients under Medicare rules, there is the potential for increased physician revenue, which can be a motivator for adoption of this new technology. The magnitude of this increase is heavily influenced by the financial details of the implementation, like the cost of the laser, the volume of surgery performed, and the incremental increase in revenue.

Summary A financial analysis should be performed prior to purchasing a femtosecond laser. This analysis can help predict if FLACS is going to be a financial windfall or a money loser.

David Geffen School of Medicine at University of California Los Angeles, Stein Eye Institute, Los Angeles, California, USA

Correspondence to John D. Bartlett, MD, Cataract and Refractive Surgery Suite, 300 Stein Plaza, University of California, Los Angeles, CA 90095, USA. Tel: +1 310 983 3865; fax: +1 310 983 2599; e-mail:

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