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    Is Ophthalmic Office-Based Surgery Safe and Effective?

    50,000+ Successful Outcomes Validate Safety of Office-Based Surgery

    A study published in the Journal of Cataract & Refractive Surgery on office-based ophthalmic surgery safety. The study reviewed 18,005 cases of office-based cataract or refractive lens surgery performed at 36 clinical sites between August 2020 and May 2022. The rates of postoperative endophthalmitis, toxic anterior segment syndrome (TASS), and corneal edema were 0.028%, 0.022%, and 0.027% respectively. Unplanned vitrectomy was performed in 0.177% of patients. While 0.067% of patients needed to return to the OR, and 0.011% of patients were referred to the hospital.1

    Author Lance Kugler, MD, recaps his findings on the safety of office-based cataract surgery with Ophthalmology Times© at ASCRS 2023.

    The above referenced study examined cases through May 2022, however, the number of office-based cataract or refractive lens surgeries has continued to increase and is reaching a tipping point. Since the time of this study, iOR Partners has been adding to this research, with data from 30,000+ real-world cases that also match or exceed safety outcomes in other settings.

    Additionally, a Kaiser Permanente published a landmark study on 21,501 cataract cases performed in an office setting—the largest US study investigating the safety and effectiveness of office-based cataract surgery performed in MPRs to that point. What they found was transformative. According to the data, office-based efficacy outcomes were consistently excellent, with a safety profile expected of minimally invasive cataract procedures performed in ASCs and HOPDs.2

    Combined data from the iRWD (iOR Real-World-Data) Registry and the Kaiser study show 50,000+ successful outcomes in the office setting.

    Studies support that OBS Outcomes match or exceed safety outcomes in other settings

    Data demonstrates the rate of post-surgical complications and infections resulting from ophthalmologic surgery in both surgical facilities and in office-based surgery as exceedingly low.

    Examples include the following bodies of research: 

    IRIS Registry: Endophthalmitis After Cataract Surgery – American Academy of Ophthalmology3

    In post-surgical patient studies, the American Academy of Ophthalmology found that endophthalmitis occurred in the following percentages: 

    • 0.04% of standalone cases
    • 0.20% of patients who underwent a concomitant ophthalmic surgery
    • 0.35% among patients with anterior vitrec­tomy
    • Similarly, in iOR Partners’ office based surgical suites, there was a reported 0.027% overall incidence.
    ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery4

    In post-surgical patient studies, ESCRS found that endophthalmitis occurred in the following percentages:

    • 23 cases in 6,862 (0.34%) patients without intracameral antibiotics
    • 5 cases in 6,836 (0.07%) patients with intracameral cefuroxime
    • Comparatively, iOR Partners found 5 cases in 18,539 (0.020%) as an overall incidence.
    Rate of Unplanned Vitrectomies in Femtosecond Laser-Assisted Cataract Surgery Compared to Conventional Phacoemulsification5

    In post-surgical patient studies, PubMed.com found that unplanned vitrectomies occurred in the following percentages:

    • 16/2,480 – (0.65%) FLACS
    • In iOR Partners’ office based surgical suites, there was a reported 0.65% overall incidence.

    iOR Suites are built on a solid foundation of patient safety and efficacy. iOR Partners collects data on cases performed in iOR Surgical Suites as part of our accreditation program. Occurrence data is collected quarterly from performed in multiple centers and different surgical techniques. Data from over 30,000 real-world cases performed in an office-based surgery facility match or beat safety outcomes in other outpatient settings. View iOR Safety Data.

    Learn More About iOR Surgical Suites

     1 Kugler L, Kapeles M, Durrie D. Safety of Office-Based Lens Surgery: A U.S. Multicenter Study. J Cataract Refract Surgery. 2023 June 5.

    2 Ianchulev T, Litoff D, Ellinger D, Stiverson K, Packer M. Office-Based Cataract Surgery: Population Health Outcomes Study of More than 21 000 Cases in the United States. Ophthalmology. 2016 Apr;123(4):723-8.

    3 Pershing S, Lum F, Hsu S, Chiang M, Rich W, Parke D.  Endophthalmitis after Cataract Surgery in the United States. Ophthalmology.  2020; 127 (2): 151-158.

    4 Barry P, Seal D, Gettinby G, Lees F, Peterson M, Revie C. ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery: Preliminary report of principal results from a European multicenter study. J Cataract Refract Surgery. 2006 Mar;32(3):407-10.

    5 Song C, Baharozian C, Hatch K, Grassett G, Talamo J. Rate of Unplanned Vitrectomies in Femtosecond Laser-Assisted Cataract Surgery Compared to Conventional Phacoemulsification. J Cataract Refract Surgery. 2018 Sep 1; 34(9):610-614.