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Oklahoma judge rules ODs cannot use lasers
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OKLAHOMA CITY — A district judge here has ruled that under Oklahoma law only licensed physicians are authorized to perform surgery with lasers.
The ruling, by Oklahoma County District Judge Eugene Matthews, overturned a 1993 decision by the Oklahoma Board of Examiners in Optometry that allowed optometrists to use lasers. The decision came in response to a complaint filed by the Oklahoma Board of Medical Licensure and Supervision and supported the claim that the use of lasers by optometrists is an unauthorized practice of medicine.
ODs had YAG since 1988
According to David A. Cockrell, OD, vice president of the Oklahoma Board of Optometric Examiners, optometrists have used lasers since 1988 for YAG capsulotomy and since the early 1990s for argon laser trabeculoplasty (ALT). A few Oklahoma optometrists have performed photorefractive keratectomy (PRK).
In a release issued by the American Academy of Ophthalmology (AAO), David Selby, MD, president of the Oklahoma State Medical Association, said "Judge Matthews' ruling clarifies the surgery issue and protects the public."
Also, Stephen A. Obstbaum, MD, president of AAO, said while "optometrists are a valuable part of the eye care team," laser surgery should not be within their scope of practice.
Dr. Cockrell said although outcomes data from several thousand cases were available, they were not considered by Judge Matthews. And Saundra Gragg, executive director of the Oklahoma Optometric Association, said the decision "was not based on evidence of malpractice or evidence of harm. There are no patient complaints to either board."
Focus was on excimer procedures
While the "vast majority" of laser procedures performed by optometrists were YAG and ALT, Dr. Cockrell said, the case focused on excimer procedures. Ms. Gragg added, "The medical board's case focused almost totally on PRK and laser-assisted in situ keratomileusis, a strategy that was evidently effective. The press and the public were more mesmerized by that kind of scenario.
Dr. Cockrell said the Board of Examiners is now meeting to consider its options. Ms. Gragg said optometrists hope the courts will issue a stay while the case is appealed. She said ODs practice in 71 of 77 Oklahoma counties; ophthalmologists practice in only 23 counties.
"We're concerned about the negative impact on patients, because doctors of optometry provide the greatest proportion of eye care in Oklahoma," she said. "Continuity of care is important in our health reform," she said.
For Your Information:
- The Oklahoma Optometric Association can be reached at (405) 524-1075; fax: (405) 524-1077. David A. Cockrell, OD, can reached at (405) 372-1715; fax: (405) 373-3350.
- The American Academy of Ophthalmology can be reached at 655 Beach Street, P.O. Box 7424, San Francisco, CA 94120-7424; (415) 561-8500; fax: (415) 561-8533.