The Economics of Femtosecond Laser-assisted Cataract Surgery

John D. Bartlett; Kevin M. Miller


Curr Opin Ophthalmol. 2016;27(1):76-81. 

In This Article


All medical practices require, as a necessity, that they run as efficient businesses. They must generate sufficient revenue to cover expenses. As the heath care environment becomes more and more cost conscious, we can expect continued downward pressure on reimbursements, especially for more expensive and common items like cataract surgery. We can also expect more shifting of financial risk from patients and insurers to physicians. Naturally as this occurs physicians will looks for ways to supplement revenue. Premium refractive surgery in conjunction with cataract surgery has proven to be profitable but we cannot assume that other new technologies, such as FLACS, will automatically have the same level of success.

Our scenarios have tried to present some information regarding the financial viability of FLACS for average ophthalmology practice conditions but any practice considering such a large investment of capital and other resources should conduct their own analysis based on assumptions that they feel are most predictive for their unique practice circumstances. The numbers that are the basis of our scenarios are speculative as the literature reports widely varying utilization rates, costs, and laser charges. Still the scenarios should be illustrative.

Looking at our numbers, it seems that practices with higher volumes and efficiency, that have average or lower than average current premium lens usage rates, and that can share a laser with multiple surgeons to lower overhead, stand the best chance of integrating FLACS over the long term. These practices, especially if they are located in more affluent areas, may very well find that FLACS can supplement revenue. Other practices, however, may find that they are better off waiting for more evidence of utility or lower costs before proceeding to purchase a femtosecond laser.