Office-based ophthalmic surgery can be performed safely
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SAN FRANCISCO — Office-based surgery can be performed safely across several different ophthalmic procedures, according to a study of real-world procedures presented at the American Academy of Ophthalmology meeting.
Daniel S. Durrie, MD, said the in-office surgery movement has been steadily growing, and more centers are becoming interested in building an office-based surgical suite.
“You can feel these movements in ophthalmology coming,” he said. “It’s been developing over the last 10 years, but it is becoming a hot topic at this and other meetings.”
A retrospective analysis of case records involved consecutive patients from 57 private practice sites in the United States, including patients who underwent office-based procedures for cataract, refractive lens exchange, ICLs, retina, glaucoma, cornea and oculoplastics.
Out of 47,714 cases, there were seven reported cases of endophthalmitis (0.015%), 94 of unplanned vitrectomy (0.198%), 38 referred to retina (0.08%), 40 with a return to the operating room (0.084%), eight of toxic anterior segment syndrome or significant iritis (0.016%), and eight of corneal edema (0.016%); 911 was called in one case (0.002%), and two patients were referred to the hospital (0.004%).
In a separate survey on anesthesia experience comprising 11,004 cases at 32 centers, 95% were done with class A oral or topical anesthesia, 0.063% were canceled preop due to high blood pressure and 911 was called in one case (0.009%). There were no cases with anesthesia complications.
Durrie said he has a personal checklist when it comes to new technology or services. The two most important factors are, is it safe and is it effective.
“With appropriate protocols and following good surgery, I think that these can be done safely,” Durrie said. “What’s really opened my eyes is the value of real-world databases, where you count every case all the time and you can analyze it afterwards.”
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Durrie DS, et al. Ophthalmic office-based surgery: Safety outcomes from 47,714 real-world procedures. Presented at: American Academy of Ophthalmology meeting; Nov. 3-6, 2023; San Francisco.
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