title: [Optimizing the financial impact of transitioning to transconjunctival vitrectomy and microincisional phacoemulsification].
abstract: OBJECTIVE
  To report the financial impact of using modern lens and vitreoretinal surgical techniques.
  
  
  METHODS
  Bottom-up sterilization and consumables costs for new surgical techniques (microincisional coaxial phacoemulsification and transconjunctival sutureless vitrectomy) and the corresponding former techniques (phacoemulsification with 3.2-mm incision and 20G vitrectomy) were determined. These costs were compared to each other and to the target costs of the Diagnosis Related Groups for public hospitals (Groupes Homogènes de Séjours [GHS]) concerned, extracted from the analytic accounting data of the French National Cost Study (Étude Nationale des Coûts [ENC]) for 2009 (target=sum of sterilization costs posted under medical logistics, consumables, implantable medical devices, and special pharmaceuticals posted as direct expenses).
  
  
  RESULTS
  For outpatient lens surgery with or without vitrectomy (GHS code: 02C05J): the ENC's target cost for 2009 was 339€ out of a total of 1432€. The cost detailed in this study was 4 % higher than the target cost when the procedure was performed using the former technique (3.2mm sutured incision) and 12 % lower when the procedure was performed using the new technique (1.8mm sutureless) after removing now unnecessary consumables and optimization of the technique. For level I retinal detachment surgeries (GHS code: 02C021): the ENC's 2009 target cost was 641€ out of a total of 3091€. The cost specified in this study was 1 % lower than the target cost when the procedure was done using the former technique (20-G vitrectomy) and 16 % less when the procedure was performed using the new technique (transconjunctival vitrectomy) after removal of now unnecessary consumables and optimization of the technique.
  
  
  CONCLUSIONS
  Contrary to generally accepted ideas, implementing modern techniques in ocular surgery can result in direct cost and sterilization savings when the operator takes advantage of the possibilities these techniques offer in terms of simplification of the procedures to do away with consumables that are no longer necessary.
authors.affiliation: Service d'ophtalmologie, université Lyon-1, hôpital E.-Herriot, hospices civils de Lyon, CHU de Lyon, 5, place d'Arsonval, 69437 Lyon cedex 03, France. Electronic address: dr.cornut@gmail.com.
authors.forename: P-L
authors.initials: PL
authors.lastname: Cornut
authors.forename: Y
authors.initials: Y
authors.lastname: Soldermann
authors.forename: C
authors.initials: C
authors.lastname: Robin
authors.forename: R
authors.initials: R
authors.lastname: Barranco
authors.forename: A
authors.initials: A
authors.lastname: Kerhoas
authors.forename: C
authors.initials: C
authors.lastname: Burillon
mesh_terms: D002387:Cataract Extraction / Q000009:adverse effects / Q000191:economics / Q000379:methods; D004059:Diffusion of Innovation; D005602:France; D017048:Health Care Costs; D006801:Humans; D062069:Inventions / Q000191:economics; D008866:Microsurgery / Q000009:adverse effects / Q000191:economics* / Q000379:methods; D018918:Phacoemulsification / Q000009:adverse effects / Q000191:economics* / Q000379:methods; D011183:Postoperative Complications / Q000191:economics / Q000601:surgery; D012163:Retinal Detachment / Q000191:economics / Q000601:surgery; D013536:Suture Techniques / Q000009:adverse effects / Q000191:economics; D014821:Vitrectomy / Q000009:adverse effects / Q000191:economics* / Q000379:methods
keywords: Cristallin; Financial; Financier; Lens; Microincisional; Mini-incision; Phacoemulsification; Phakoémulsification; Transconjunctival vitrectomy; Vitrectomie transconjonctivale