PMID- 26804760
OWN - NLM
STAT- MEDLINE
DCOM- 20160811
LR  - 20220410
IS  - 1549-4713 (Electronic)
IS  - 0161-6420 (Linking)
VI  - 123
IP  - 4
DP  - 2016 Apr
TI  - Office-Based Cataract Surgery: Population Health Outcomes Study of More than 21 
      000 Cases in the United States.
PG  - 723-8
LID - S0161-6420(15)01489-X [pii]
LID - 10.1016/j.ophtha.2015.12.020 [doi]
AB  - PURPOSE: To identify safety and effectiveness outcomes of office-based cataract 
      surgery. Each year, approximately 3.7 million cataract surgeries in the United 
      States are performed in Ambulatory Surgery Center (ASC) and Hospital Outpatient 
      Department (HOPD) locations. Medicare in July 2015 published a solicitation for 
      expert opinion on reimbursing office-based cataract surgery. DESIGN: Large-scale, 
      retrospective, consecutive case series of cataract surgeries performed in Minor 
      Procedure Rooms (MPRs) of a large US integrated healthcare center. PARTICIPANTS: 
      More than 13 500 patients undergoing elective office-based cataract surgery. 
      METHODS: Phacoemulsification cataract surgery performed in MPRs of Kaiser 
      Permanente Colorado from 2011 to 2014. MAIN OUTCOME MEASURES: Postoperative 
      visual acuity and intraoperative and postoperative adverse events (AEs). RESULTS: 
      Office-based cataract surgery was completed in 21 501 eyes (13 507 patients, age 
      72.6+/-9.6 years). 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%). Postoperative mean best-corrected visual acuity 
      measured 0.14+/-0.26 logarithm of the minimum angle of resolution units. 
      Intraoperative ocular AEs included 119 (0.55%) cases of capsular tear and 73 
      (0.34%) cases of vitreous loss. Postoperative AEs included iritis (n = 330, 
      1.53%), corneal edema (n = 110, 0.53%), and retinal tear or detachment (n = 30, 
      0.14%). No endophthalmitis was reported. Second surgeries were performed in 0.70% 
      of treated eyes within 6 months. There were no life- or vision-threatening 
      intraoperative or perioperative AEs. CONCLUSIONS: This is the largest US study to 
      investigate the safety and effectiveness of office-based cataract surgery 
      performed in MPRs. Office-based efficacy outcomes were consistently excellent, 
      with a safety profile expected of minimally invasive cataract procedures 
      performed in ASCs and HOPDs.
CI  - Copyright (c) 2016 American Academy of Ophthalmology. Published by Elsevier Inc. 
      All rights reserved.
FAU - Ianchulev, Tsontcho
AU  - Ianchulev T
AD  - University of California, San Francisco, San Francisco, California. Electronic 
      address: sean@ianchulev.com.
FAU - Litoff, David
AU  - Litoff D
AD  - Colorado Permanente Medical Group, Lafayette, Colorado.
FAU - Ellinger, Donna
AU  - Ellinger D
AD  - Colorado Kaiser Permanente Health Plan, Wheat Ridge, Colorado.
FAU - Stiverson, Kent
AU  - Stiverson K
AD  - Colorado Permanente Medical Group, Lone Tree, Colorado.
FAU - Packer, Mark
AU  - Packer M
AD  - Oregon Health & Science University, Portland, Oregon.
LA  - eng
PT  - Journal Article
DEP - 20160122
PL  - United States
TA  - Ophthalmology
JT  - Ophthalmology
JID - 7802443
SB  - IM
CIN - Ophthalmology. 2017 Jan;124(1):e11-e12. PMID: 27993271
CIN - Ophthalmology. 2017 Jan;124(1):e12. PMID: 27993273
MH  - Aged
MH  - Aged, 80 and over
MH  - Ambulatory Care Facilities/standards
MH  - Ambulatory Surgical Procedures/adverse effects/*standards
MH  - Databases, Factual
MH  - Female
MH  - Humans
MH  - *Intraoperative Complications
MH  - *Lens Implantation, Intraocular
MH  - Male
MH  - Middle Aged
MH  - Outcome and Process Assessment, Health Care
MH  - Phacoemulsification/adverse effects/*standards
MH  - *Postoperative Complications
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - United States
MH  - Visual Acuity/*physiology
EDAT- 2016/01/26 06:00
MHDA- 2016/08/12 06:00
CRDT- 2016/01/26 06:00
PHST- 2015/10/17 00:00 [received]
PHST- 2015/12/14 00:00 [revised]
PHST- 2015/12/14 00:00 [accepted]
PHST- 2016/01/26 06:00 [entrez]
PHST- 2016/01/26 06:00 [pubmed]
PHST- 2016/08/12 06:00 [medline]
AID - S0161-6420(15)01489-X [pii]
AID - 10.1016/j.ophtha.2015.12.020 [doi]
PST - ppublish
SO  - Ophthalmology. 2016 Apr;123(4):723-8. doi: 10.1016/j.ophtha.2015.12.020. Epub 
      2016 Jan 22.