Office-Based Surgery Occurrence Data

Office-Based Surgery Is Safe & Effective

Office-based surgery provides safe and effective outcomes that are comparable or superior to those performed in an ASC while also streamlining patient care.

The largest U.S. retrospective study of 21,501 cataract surgeries (13,507 patients, age 72.6 ±9.6 years) conducted in the Denver metropolitan area Kaiser office from 2011-2014 found that OBS efficacy outcomes were consistently excellent, with a safety profile expected of minimally invasive cataract procedures performed in ASCs and HOPDs. Phacoemulsification was performed in 99.9% of cases, and manual extracapsular extraction was performed in 0.1% of cases. Systemic comorbidities included hypertension (53.5%), diabetes (22.3%), and chronic obstructive pulmonary disease (9.4%). Good visual outcomes and safety were reported with postoperative mean best-corrected visual acuity measured 0.14±0.26 logarithm of the minimum angle of resolution units.

In over 18,000 procedures performed in iOR facilities, our safety profile is consistently as good or better as those in the Kaiser study.

iOR Partners Safety Occurrence Data

iOR occurrence data is collected quarterly from iOR Suites nationwide.

Total Cases

  • Data collected as part of each center’s quarterly Quality Accreditation Program
  • Consecutive series from the first case performed in OBS
  • 100% of centers included
  • Real world data with multiple different surgical techniques
  • Data is updated every quarter and is publicly available
  • Lance Kugler, MD is submitting this data set for publication
Endophthalmitis 0.027%
Unplanned Vitrectomy 0.162%
Referred to Retina 0.070%
Return to the OR 0.054%
(most for removal of residual cortex)
TASS or significant iritis 0.022%
(single outbreak at 1 center)
Corneal Edema 0.016%
Referred to Hospital 0.011%
(nausea and unable to keep food and fluids down, previously undiagnosed A. Fib)

Patient Group 65 and Older

  • The overall average age of the total cases is 64.7 years
  • This group is just the patients 65 or older – 9,723 cases
  • Slight increase in unplanned vitrectomy and referral to retina
  • Overall occurrence rates similar to total cohort
Endophthalmitis 0.031%
Unplanned Vitrectomy 0.237%
Referred to Retina 0.113%
Return to the OR 0.072%
(most for removal of residual cortex)
TASS or significant iritis 0.000%
Corneal Edema 0.021%
Referred to Hospital 0.021%
(previously undiagnosed A. Fib)

Retina Only

  • Numerous retina practices are interested in OBS
  • 80% of all retinal cases are still performed in a hospital setting
  • Vitrectomy procedures have been performed safely and effectively in an accredited OBS
  • Gene therapy, sustained release intravital medication and treatments for geographic atrophy are increasing the pressure on efficiency in retinal practices
Endophthalmitis 0.0%
Retrobulbar hemorrhage 0.0%
Referred for additional Surgery 0.0%
Unplanned return to the OR for the same procedure 0.0%
Significant iritis 0.000%
Unplanned detachment 0.0%
Referred to Hospital 0.0%

Anesthesia Survey Data

  • A separate survey was done on anesthesia experience
  • 32 centers – 11,004 cases
  • OBS anesthesia types
  • Class A – oral/topical
  • Class B – IV sedation with standby anesthesia
  • Most centers started with Class B for the first few week’s cases
  • Majority of surgeons, staff and patients prefer Class A
% of cases done with Class A (oral/topical) anesthesia 95%
(average of all cases)
% of cases with anesthesia complications 0.0%
% of cases that were canceled in preop 0.063%
(all were from blood pressure that was too high)
% of cases that emergency (911) was called 0.009%
(1 case: Patient had chest pain, 911 was called, came and diagnosed as an anxiety attack and discharge to home and did fine)

Comorbidity Survey Data

71% of Patients Shown to Have Comorbidities

4,399 Patients

  • Diabetes 20.03%
  • Hypertension 50.47%
  • Heart Disease 11.28%
  • Pulmonary Disease 6.62%
  • Arthritis 15.44%
  • Allergies 18.80%
  • Bleeding Risk 5.00%

Number of Comorbidities

  • 0 (39.03%)
  • 1 (33.48%)
  • 2 (18.28%)
  • 3 (5.93%)
  • 4 (2.34%)
  • 5 (0.66%)
  • 6 (0.09%)

Antibiotic Review Results

July 2022, 40 Centers

21,031 Cases

  • 15,145 with Intracameral ABX  = 72%
  • 77% ABX only
  • 18% Anti-inflammatory/ABX
  • 5% Anti-inflammatory/ABX/NSAID

Out of the 5,886 cases that do not inject:

  • 43% use ABX GTTS
  • 8% Irrigate with BSS/ABX Solution