Is Office-Based Surgery Safe?
When considering office-based surgery suite for your practice, safety is the primary concern. Lance Kugler, MD of Kugler Vision in Omaha, NE shares his findings on the safety of office-based surgery for cataracts. He built an accredited office-based surgery center with the same or better standards for eyes that an ASC requires. In this video he shares data from a large study and compares to his own OBS data with similar outcomes.
:00 My biggest concern was safety. I think that’s everybody’s first concern because when you hear about an office based center you think it’s a clean room or a procedure room, and it didn’t take me very long to realize that this isn’t what this is, this is operating rooms that are in your office, they’re classified differently.
:26 What I learned what we could do with an office-based surgery center was build something to the same or better standards for eyes that ASC’s require and that we can get accredited for that. We can build an accredited center in our office that’s as safe or safer than an ASC. That helped me really feel comfortable with that.
:47 Okay, so again there was this study out of the Kaiser group, Mark Packer and his group came out with this in 2016 actually, 2015 data. A really nice study, and basically the summary is is that they looked at in-office versus comparable ASC data and they found that endophthalmitis was actually less in their (this is a big study, 21,000 patients, 21,501 eyes) endophthalmitis rate is 0%, retinal detachment is actually better than ASC data, vitreous loss was better than ASC data, and perioperative AE was negligible with zero in both.
1:29 What’s nice about coming into the office space surgery now, which I didn’t have this data in 2015 when I was looking at this, but now we do. If you look at iOR’s internal data from their office based surgery experience have 5,000 IOL surgeries now. The data compares actually a little bit better than what the Kaiser study did. Kaiser was comparing ASC to office base and now we’re comparing our current version of office base to what was being done three or four years ago and we’re finding that it’s improved even more since then. That data’s been helpful in establishing a safety in a scientific way, but what I’ve found anecdotally in our experience is our own internal rates I feel more comfortable operating in our center than I do at ASC. I have a fellow with me the past year and a half and his comment was he vastly preferred doing surgery in our center compared to the ASC and that was somebody that was just coming in very raw. All that leads to the same conclusion, which was safety’s been something we feel really good about.