To the Editor An additional comment on the cost-analysis model comparing immediate sequential cataract surgery (ISCS) with delayed sequential cataract surgery (DSCS) in the United States from the societal and physician perspectives would be beneficial.1,2 Physicians were shown to have a decline in physician practice–derived income with a conversion to ISCS.2 Because many physicians have an ownership stake in ambulatory surgery centers (ASCs), an additional negative impact on physicians’ incomes could occur if ASCs experience a decline in profitability from ISCS conversion. The cost-analysis model was updated to examine the financial impact of ISCS conversion on ASCs.