Is Office-Based Ophthalmic Surgery Safe and Effective?

The short answer is, yes. 

Learn more about the data backing the integrity of office based surgery (OBS), and how you can expand your clientele by partnering with an industry expert to grow your practice.

Data reflects overwhelming volume of OBS cases safely performed

An upcoming 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. Publication of the study results are expected in the spring of 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.

Studies support ophthalmologic procedures as similar low-risk in OBS setting 

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 Ophthalmology

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 surgery

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 Phacoemulsification

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.

 1Pershing 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.

2Barry 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.

3Song 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.

At iOR, our office-based surgery program is built on a solid foundation of patient safety and efficacy. 

Since 2015, iOR has helped lead the industry in proving that cataract surgery can be safely and effectively performed in the office setting.

Learn more and see if you’re a candidate for OBS at https://iorpartners.com/free-analysis/

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