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Archive June 2016 XVII, No. 6

The Future of Cataract Surgery

These advances will innovate your ophthalmic ORs.

David Bernard, Senior Associate Editor


cataract surgery CHANGE OF VENUE Will cataract surgery migrate from hospitals and surgery centers to offices?

What will cataract surgery look like 10 or 20 years from now? Hard to say, but the ophthalmic OR is bound to be a lot different than it is today. "If you look back 50 years at what we were doing in cataract surgery, it's night and day compared to now," says George O. Waring IV, MD, FACS, director of refractive surgery and an associate professor of ophthalmology at the Medical University of South Carolina in Charleston. One thing observers are sure of: Case volumes will rise. Here are some possibilities that they see in the busy decades ahead.

1. Office-based cataracts. Office-based surgery is likely to become standard care for routine cataracts and lens replacements, driven largely by their minimally invasive techniques, the successes of LASIK suites and the desire to create a better patient experience, says Dr. Waring. "We'll be looking to our dental and oral surgery colleagues, who do many things well in terms of patient service," he says, adding that ophthalmology's trend toward oral sedation and minimal IV sedation "fits into this paradigm nicely." Offices won't be able to accommodate general anesthesia, special equipment and the complex cases they support, but they could make cataract surgery more approachable for patients, he says.

Medicare doesn't currently reimburse office-based cataracts, but the agency has reportedly considered the subject. Keep in mind, though, that even self-pay cases face roadblocks at present. "The fact that it's technologically feasible, and it is, doesn't mean it's economically feasible yet," says Steve Sheppard, CPA, COE, managing principal of the Medical Consulting Group in Springfield, Mo. Renovating, equipping and staffing a space to meet state-specific requirements and to handle surgery's demands could take several solidly scheduled years to break even, he notes. Additionally, physician-owners might not see a financial incentive to export ASC cases to office suites.

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