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Air quality in different surgery centers
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To the Editor:
I always enjoy your insights, but in your commentary in the May 25, 2017, issue of Ocular Surgery News, you seemed to lump together ASC and office-based ORs. You briefly touched on an important point that is often not discussed in this debate — air quality.
As I am sure you know, ASC ORs are required to have positive pressure ventilation similar to hospital-based ORs. There are also requirements regarding air quality, temperature and humidity.
I would argue that most ophthalmology offices do not have this type of air/ventilation control. Furthermore, it would be expensive to implement in most offices.
If cataract surgery moves to an office OR, then the same regulators that currently inspect our ASC OR ventilation and air would have to inspect the office-based OR ventilation and air to make sure they are up to the same standard. Otherwise, to be fair, the ASCs should no longer be held to that standard.
Michael Rizen, MD, PhD
Bellevue, Washington
Dr. Lindstrom responds:
I agree with Dr. Rizen that we cannot compromise the quality of the surgery environment, whether it is labeled an ambulatory surgery center or office surgery center (OSC). Hopefully regulatory burdens in an OSC will be lower. They are today. The other side of the challenge is, of course, reimbursement. If we trend away from fee for service toward some form of capitation, reimbursement will be the same regardless of where the procedure is performed. I see this as a major driver toward bilateral same-day sequential cataract surgery in an OSC as the dominant approach in a decade.
Richard L. Lindstrom, MD
OSN Chief Medical Editor