title: Cost of phacovitrectomy versus vitrectomy and sequential phacoemulsification.
abstract: OBJECTIVE
  To evaluate and compare the cost of combined pars plana vitrectomy and phacoemulsification/intraocular lens implantation (phacovitrectomy) to a sequential approach to the surgical procedures for patients with an indication for vitrectomy and a visually significant cataract.
  
  
  METHODS
  The total cost of both the combined and sequential approaches to surgery were calculated by combining the surgeon, ambulatory surgical center, and anesthesiology fees as reimbursed by Medicare. A univariate sensitivity analysis was also performed to examine the sensitivity of our estimations to changes in surgical duration.
  
  
  RESULTS
  Phacovitrectomy afforded a 17% to 20% per-patient cost savings to Medicare (depending on the type of vitrectomy) compared with vitrectomy with sequential phacoemulsification. The conclusion that phacovitrectomy was less expensive than sequential surgery was robust in sensitivity analysis.
  
  
  CONCLUSIONS
  Phacovitrectomy seems to be significantly less costly to Medicare than a sequential approach to surgery for patients with an indication for vitrectomy and a visually significant cataract.
authors.affiliation: *Department of Ophthalmology, University of California San Francisco, San Francisco, California; †Permanente Medical Group-Hayward, Hayward, California; and ‡Private Practice, Albany, New York.
authors.forename: Michael I
authors.initials: MI
authors.lastname: Seider
authors.forename: J
authors.initials: J
authors.lastname: Michael Lahey
authors.forename: Paul S
authors.initials: PS
authors.lastname: Fellenbaum
mesh_terms: D003365:Costs and Cost Analysis; D017048:Health Care Costs; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000191:economics*; D018918:Phacoemulsification / Q000191:economics*; D012164:Retinal Diseases / Q000601:surgery*; D014821:Vitrectomy / Q000191:economics*