Office-based surgery ‘the way of the future’ in ophthalmology
Key takeaways:
- Office-based surgery can help surgeons capture facility fees.
- Complication rates were similar to those in ASCs.
KOLOA, Hawaii — Office-based surgery is safe and can help ophthalmology practices generate more revenue, according to a speaker at Hawaiian Eye 2025.
ASCs are growing within health care, according to Parag A. Majmudar, MD, but ophthalmology has to share space with other specialties.
“Ophthalmology is becoming sort of an afterthought,” he said. “Many of these ASCs want to do one hip replacement and make $25,000 rather than do 25 cataracts in a day, so I think we’re going to be kicked out pretty soon.”
Less than 3% of private ophthalmology practices in the U.S. have in-office surgical suites, Majmudar said, noting the difficulties practices can face in building these areas, including ownership structure, physical layout of the office space, and fear and hesitancy.
Despite these barriers, building an in-office surgical suite can be beneficial for practices financially, Majmudar said. An ASC can cost about three times as much as an office-based suite, and with an in-office suite, surgeons have the opportunity to generate more revenue by capturing facility fees, he said.
Office-based procedures are safe with complication rates similar to ASCs, Majmudar said, referencing a recent study of more than 47,000 office-based procedures with only seven occurrences of endophthalmitis and 94 unplanned vitrectomies. Only 38 patients had to be referred to retina specialists, 40 returned to the operating room and two referred to a hospital; in one case, 911 had to be called.
There are some situations in which office-based surgery is not the best choice, Majmudar said, including patients with significant comorbidities or high anxiety. His practice targets to perform about 20% of cataract cases in the office.
For surgeons who are considering office-based surgery, Majmudar urged them to work with a trusted advisor to determine if they have the kind of space that is needed and to deal with billing questions.
“This is the perfect storm,” Majmudar said. “We’ve got an aging population, we have a relative shortage of surgeons, and we’re getting kicked out of ASCs. Anesthesia has become a big issue. [Office-based surgery] is going to be the way of the future and also the present.”
Reference:
- 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.
Collapse
Majmudar PA. Office-based surgery: Is it ready for prime time? Presented at: Hawaiian Eye 2025; Jan. 18-24, 2025; Koloa, Hawaii.
Read more about