Same-Day Bilateral Cataract Surgery: Prospective Analysis of Outcomes and Economic Factors in the United States
Purpose
To investigate the visual and economic benefits of same-day bilateral cataract surgery versus separate-day bilateral cataract surgery in the United States.
Methods
A cohort of 42 subjects were prospectively selected to undergo same-day bilateral cataract surgery and were age-matched with a cohort of 42 control subjects that prospectively underwent standard separate-day bilateral cataract surgery. Postoperative clinical outcomes at 3 weeks and 3 months and various economic factors were compared among the two groups.
Results
The same-day bilateral cataract surgery group had statistically similar baseline characteristics and postoperative outcomes to the control group. The average subject in the same-day bilateral cataract surgery group had significantly less total distance traveled for care (p<0.0001), less total time spent traveling for care (p<0.0001), less total number of visits required for care (p<0.0001), and less total time for vision recovery (p<0.0001) when compared to the control group. The physician and ambulatory surgery center reimbursements were significantly lower in the same-day bilateral cataract surgery group (p=0.0028 and p=0.0016, respectively), whereas the total physician time spent caring for the patient in surgery was not statistically different among the two groups (p=0.7310), and the total ambulatory surgery center expenses were significantly higher in the same-day surgery group (p<0.0001).
Conclusion
Substantial visual and economic benefits for the patient can be achieved with same-day bilateral cataract surgery in the United States at the present time. However, safety concerns and the third-party payer financial consequences to physicians and ambulatory surgery centers performing same-day bilateral cataract surgery both remain considerable obstacles for widespread adoption. Future safety investigations and dialogue with healthcare authorities are necessary for implementation of same-day bilateral cataract surgery to occur in the United States.