Prospective analysis of outcomes and economic factors of same-day bilateral cataract surgery in the United States

J Cataract Refract Surg. 2015 Apr;41(4):732-9. doi: 10.1016/j.jcrs.2014.07.034. Epub 2015 Mar 6.

Abstract

Purpose: To evaluate the visual and economic benefits of same-day bilateral cataract surgery versus separate-day bilateral cataract surgery in the United States.

Setting: Private practice, Amarillo, Texas, USA.

Design: Prospective controlled nonrandomized clinical trial.

Methods: A cohort of patients having same-day bilateral cataract surgery was age-matched with a cohort of control patients who had standard separate-day bilateral cataract surgery. The primary outcome was a comparison of the direct cost for the patient, physician, ambulatory surgery center (ASC), and third-party payer.

Results: The same-day cohort (42 patients, 84 eyes) had similar baseline characteristics and postoperative outcomes as the control cohort (42 patients, 84 eyes). The same-day cohort had less total distance traveled for care (P = .0039 and P < .0001 for in-town and out-of-town residents, respectively), less total time spent traveling for care (P = .0008 and P < .0001 for in-town and out-of-town residents, respectively), less total number of visits required for care (P < .0001), and less total time for vision recovery (P < .0001) than the control cohort. The physician and ASC reimbursements were lower in the same-day cohort (P = .0028 and P = .0016, respectively), whereas the total physician time spent caring for the patient in surgery was not different between the 2 groups (P = .7310). The total ASC expenses were higher in the same-day cohort (P < .0001). The total third-party payer cost was significantly less in the same-day cohort (P < .0001).

Conclusion: Visual and economic benefits for the patient can be achieved with same-day bilateral cataract surgery in the U.S. at the present time.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Aged
  • Ambulatory Surgical Procedures / economics*
  • Case-Control Studies
  • Cost of Illness*
  • Economics
  • Female
  • Health Care Costs
  • Humans
  • Lens Implantation, Intraocular / economics
  • Lens Implantation, Intraocular / methods
  • Male
  • Middle Aged
  • Ophthalmology / economics*
  • Phacoemulsification / economics*
  • Phacoemulsification / methods*
  • Prospective Studies
  • Treatment Outcome
  • United States
  • Visual Acuity / physiology