Objective: The aim of the study was to conduct a health-economic analysis of two ophthalmic surgical interventions: cataract surgery and rhegmatogenous retinal detachment (RRD) surgery. Based on intraoperative phacoemulsification (PHACO) parameters, we sought to evaluate and compare the costs of cataract surgery in patients with and without pseudoexfoliation syndrome (PEX). Additionally, through a cost-utility analysis, we aimed to assess and compare the cost-effectiveness of three modern surgical techniques for RRD treatment. Methods and Participants: This retrospective quality registry-based study consists of two parts, linked by health-economic analysis into a single whole. In the first part, 5,889 patients (6,236 eyes) who underwent PHACO cataract surgery at the Eye department, Split University Hospital, over a 7-year period were included in the analysis. Patients were divided into two groups based on the presence or absence of PEX. Intraoperative PHACO parameters, intraoperative complications, and procedural costs were analyzed and compared between the groups, with a focus on differences in costs arising from the duration of surgical procedures. The appropriateness of diagnosis-related group (DRG) codes associated with PHACO cataract surgery was also evaluated. The second part included 151 patients with RRD treated at the Eye department, Split University Hospital, over a 3-year period using one of three surgical techniques: pneumatic retinopexy (PR), scleral buckling (SB), or pars plana vitrectomy (PPV). The anatomical and functional outcomes of each method were assessed. Additionally, an extensive health-economic analysis of costs and utility (measured by expected QALY values based on anatomical and functional outcomes) was performed. The cost-effectiveness of surgical techniques was compared using incremental cost-effectiveness ratio (ICER). Results: Pseudoexfoliation syndrome was diagnosed in 6.13% of cases included in the study. All intraoperative PHACO parameters were higher in the PEX group, particularly in patients with harder nuclear cataracts. The duration of the procedure was 1.5 times longer in the PEX group, and intraoperative complications were significantly more frequent. The expected costs of PHACO procedures were significantly higher in patients with PEX, regardless of nuclear cataract hardness (especially in patients with harder nuclei). These costs were not covered by the current DRG reimbursement system, leading to an expected unreimbursed cost loss per procedure ranging from 36% to as high as 69%. In the second part of the study, primary anatomical success was achieved in 86% of patients treated for RRD. There was no statistically significant difference in anatomical success among the three surgical techniques. However, functional outcomes (based on final visual acuity) significantly differed between the techniques. Consequently, expected QALY values also significantly varied, being lower for PPV compared to PR and SB. Furthermore, PR demonstrated dominant cost-effectiveness compared to PPV, with a cost-effectiveness ratio of -6,253 €/QALY. Conclusion: The study revealed that costs associated with PHACO cataract surgery in patients with PEX are significantly higher than in those without PEX and are not adequately covered by the current DRG system. This underscores the need to adjust the DRG reimbursement system for PHACO procedures in PEX patients, particularly those with harder nuclei. Adjustments and supplements to DRG reimbursement codes are also needed for RRD cases. The study also demonstrated that PR, in appropriate cases, is not only the most cost-effective technique for RRD repair but also yields the best functional outcomes. This should be particularly considered in countries with limited healthcare resources (such as Croatia), where decisions regarding RRD treatment should be based on cost-utility analyses.