{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T14:44:09Z","timestamp":1792161849393,"version":"4.4.0"},"reference-count":29,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of VitreoRetinal Diseases"],"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To compare real-world pediatric retinal detachment (RD) repair times with the Centers for Medicare and Medicaid Services (CMS) estimates for complex RD surgeries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A cross-sectional survey was performed of complex pediatric RD perioperative times from pediatric retina specialists across the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 152 patients were included. The mean (\u00b1SD) age at the initial visit was 9.2 \u00b1 5.8 years, and the mean (\u00b1SD) follow-up was 2.31 \u00b1 1.95 years. The most common complex pediatric RD surgeries were pars plana vitrectomy (PPV) (61%, n = 92), followed by combined scleral buckle (SB)\/PPV (21%, n = 32) and SBs (20%, n = 30). Surgeries were most commonly performed at hospitals (66%, n = 104), which were associated with longer intraoperative times than in ambulatory surgery centers (median, 150 minutes vs 121 minutes;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .004). The most common medical insurance was Medicaid (49%). There was a median of 135 minutes (interquartile range [IQR], 74\u2013200 minutes) of uncompensated physician time for patient phone calls, contacting insurances, and surgery turnover for each patient. Combined preoperative pediatric surgery times were longer in the real-world survey than CMS estimates (median, 92 minutes [IQR, 67.5\u2013120 minutes] vs 63.5 minutes [IQR, 51.5\u201364 minutes];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Real-world intraoperative times were also higher than CMS estimates (median, 141 minutes [IQR, 110\u2013192 minutes] vs 133 minutes [IQR, 120\u2013138 minutes];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .003). Approximately 38% of patients needed another surgery postoperatively, most commonly another RD repair (63%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Pediatric RD repairs may be undervalued by CMS estimates. The intraoperative times were longer, and physicians spent an extra 2.25 hours of uncompensated time caring for each child in the perioperative period. The current reimbursements may not fully account for the complexity and length of perioperative care for pediatric RDs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/24741264261490790","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T14:47:32Z","timestamp":1791989252000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-World Versus Centers for Medicare and Medicaid Services Estimates of Pediatric Retinal Detachment Repair Times"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4874-2471","authenticated-orcid":false,"given":"Ella H.","family":"Leung","sequence":"first","affiliation":[{"name":"Georgia Retina, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9541-2558","authenticated-orcid":false,"given":"Hong-Uyen","family":"Hua","sequence":"additional","affiliation":[{"name":"Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nita","family":"Valikodath","sequence":"additional","affiliation":[{"name":"W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6847-7169","authenticated-orcid":false,"given":"Yoshihiro","family":"Yonekawa","sequence":"additional","affiliation":[{"name":"Wills Eye Hospital, Mid Atlanta Retina, Thomas Jefferson University, Philadelphia, PA, USA"},{"name":"Kyorin Eye Center, Kyorin University School of Medicine, Tokyo, Japan"},{"name":"Vickie &amp; Jack Farber Vision Research Center, Wills Eye Hospital, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor M.","family":"Villegas","sequence":"additional","affiliation":[{"name":"Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA"},{"name":"Department of Ophthalmology, University of Puerto Rico, PR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audina","family":"Berrocal","sequence":"additional","affiliation":[{"name":"Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary Elizabeth","family":"Hartnett","sequence":"additional","affiliation":[{"name":"Byers Eye Institute, Stanford University, Palo Alto, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prethy","family":"Rao","sequence":"additional","affiliation":[{"name":"Retina and Vitreous of Texas, Houston, TX, USA"},{"name":"Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA"},{"name":"Houston Methodist Hospital\/Blanton Eye Institute, Weill Cornell Medical School, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1193-6686","authenticated-orcid":false,"given":"Emmanuel Y.","family":"Chang","sequence":"additional","affiliation":[{"name":"Retina and Vitreous of Texas, Houston, TX, USA"},{"name":"Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA"},{"name":"Houston Methodist Hospital\/Blanton Eye Institute, Weill Cornell Medical School, Houston, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Sisk","sequence":"additional","affiliation":[{"name":"Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, OH, USA"},{"name":"Cincinnati Eye Institute, Cincinnati, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward H.","family":"Wood","sequence":"additional","affiliation":[{"name":"Austin Retina Associates, Austin, TX, USA"},{"name":"Dell Medical School at University of Texas, Austin, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Clio Armitage","family":"Harper","sequence":"additional","affiliation":[{"name":"Austin Retina Associates, Austin, TX, USA"},{"name":"Dell Medical School at University of Texas, Austin, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celine","family":"Chaaya","sequence":"additional","affiliation":[{"name":"Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8629-1889","authenticated-orcid":false,"given":"Salma","family":"Fleifil","sequence":"additional","affiliation":[{"name":"W.K. 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