The Business of Refractive Laser Assisted Cataract Surgery (ReLACS)

John P. Berdahl; Matthew P. Jensen


Curr Opin Ophthalmol. 2014;25(1):62-70. 

In This Article

Abstract and Introduction


Purpose of review Refractive Laser Assisted Cataract Surgery (ReLACS) combines the femtosecond laser with other noncovered tests and services in an attempt to reduce spectacle dependence in combination with cataract surgery. Significant interest is present among ophthalmologists who are considering adopting this technology, however significant capital outlays and continuing expenses can make the decision to adopt ReLACS foreboding. We review the financial considerations of ReLACS and review the trends seen in early adopters of this technology.

Recent findings Recent findings have shown that ReLACS is a growing segment of cataract surgery. Most practices who have implemented the technology have broken even and have a positive outlook on the financial return of implementing the ReLACS program. The average break-even analysis point for practices is around 230 cases a year.

Summary ReLACS is growing and appears to be a financial viable approach for many practices.


Refractive Laser Assisted Cataract Surgery (ReLACS) has demonstrated tremendous interest with tremendous growth in the ophthalmology industry as its introduction just over 2 years ago. ReLACS applies the femtosecond laser to cataract surgery in an attempt to increase the precision, reproducibility, accuracy, and perhaps even the safety of traditional cataract surgery. Traditional cataract surgery in its current for is both safe and accurate, however the refractive outcomes are less precise than LASIK, which sets a standard of 55% of patient within 0.5 D of target. The femtosecond laser in combination with the software platform creates the capsulotomy, lens fragmentation, arcuate incisions, paracenteses, primary incisions and, in some cases, a lamellar corneal flap. Essentially, the laser takes the most delicate steps of the cataract surgery out of the surgeon's hands and performs them with unbeatable precision. In this issue of Current Opinion of Ophthalmology, others will describe the clinical utility of the femtosecond laser when used for cataract surgery, while this article will describe the business considerations for ReLACS.

When incorporating any new technology, the first question a practice should ask itself is, 'Why should I incorporate this new technology into my practice?' The answer to this question should always be 'because I believe this will help my patient.' Profits are a downstream effect of the services that we provide. We all took an oath to do the right thing for our patients and we did not take an oath to maximize our profit margins. Therefore, the business model of ReLACS must provide fair value to both the practice implementing the technology and the patient who is benefiting from the technology. Below is the description of the key factors that must be understood when implementing the business side of ReLACS.