OBJECTIVES: The costs associated with complications during and following cataract surgery are not well documented in the literature. This study aimed to determine the routine treatment of cataract surgery complications through discussions with an expert panel, and to determine the costs of the complications from a US provider perspective through a microcosting approach.

METHODS: Three US ophthalmologists were interviewed about the additional operating room (OR) time and materials required to treat complications intraoperatively, and additional clinical visits and procedures required for postoperative treatment. Input from the three experts was used to microcost five complications from the US provider perspective: posterior capsule rupture (PCR), corneal burn, cystoid macular edema (CME), corneal edema, and elevated intraocular pressure (IOP). Costs were estimated based on published literature, where available, and costs/payments reported by the Centers for Medicare and Medicaid Services. Costs are reported in 2021 US dollars.

RESULTS: Cost per patient was calculated. The cost of PCR was $1,776, including additional OR time (39 minutes) and materials, and additional physician visits, imaging, and procedures (eg, laser vitreolysis). The cost of corneal burn ranged from $35 (mild) to $716 (severe), including additional OR time (up to 27 minutes) and materials, and additional physician visits. The cost of CME, corneal edema, and elevated IOP ranged from $64 (mild) to $133 (severe), $12 (mild) to $121 (severe), and $0 (mild) to $230 (severe), respectively, including additional physician visits and procedures (eg, paracentesis).

CONCLUSION: Intraoperative complications (PCR and corneal burn) were associated with the highest costs to providers due to the additional OR time and materials required. Providers also incur costs related to additional follow-up visits and procedures for both intraoperative and postoperative complications. This study addresses the current literature gap and can be used to inform future economic analyses for interventions designed to reduce cataract surgery complications.