A recent survey conducted by the American Optometric Association (AOA) Research & Information Committee (RIC) gathered real-world data from optometrists (ODs) in 10 states where ODs are certified to perform in-office laser procedures (capsulotomies) following cataract surgery.
So which states can ODs perform capsulotomies in?
As of 2023, the following states permit ODs to perform such advanced procedures
- Alaska (passed in 2017)
- Arkansas (passed in 2019)
- Colorado (passed in 2022)
- Indiana (passed in 2015)
- Kentucky (passed in 2011)
- Louisiana (passed in 2014)
- Mississippi (passed in 2021)
- Oklahoma (passed in 1998; the first)
- Virginia (passed in 2022)
- Wyoming (passed in 2021)
To note, more than half of these states passed laws just in the last 5 years.
Why YAG?
ODs typically diagnose posterior capsule opacification (PCO)—one of the most common complications following cataract surgery—during comprehensive eye exams. The condition can develop within 2 to 5 years or even mere months post op.
To treat this, the YAG capsulotomy procedure can be performed in-office and typically can take around 5 minutes.
Now talk about this survey.
Conducted in April 2023 (April 5 to 28), the AOA sent the online survey to 5,645 ODs licensed and practicing in 10 targeted states; of that number, 406 ODs responded.
The states included:
- Alaska
- Arkansas
- Colorado
- Indiana
- Kentucky
- Louisiana
- Mississippi
- Oklahoma
- Virginia
- Wyoming
Results?
A total of 56% of respondents indicated that they are currently performing YAG laser capsulotomies in their practices, while 17% reported they are awaiting regulations to be finalized.
Subsequently, 89% also indicated that they have the availability to perform YAG on patients within one week (or less).
What did they say about MD-performed YAG procedures?
The respondents reported that only 9% of their patients who were referred to an MD for YAG were able to see the MD in one week or less.
Additionally, they reported that—prior to the scope of expansion laws for ODs—64% of patients were waiting 3+ weeks to see an MD for YAG; one-third of respondents also reported their patients had to travel 30+ miles and wait 45+ minutes or more for the procedure after arriving at their MD appointment.
And how does this compare to ODs?
The respondents reported that 35% of YAG procedures they perform are done in-office on the same day.
Further, 97% reported their patients were satisfied with the convenience—and 46% reported patient satisfaction with the direct cost savings—of in-office YAG .
Where can I find more results from this survey?
Click here to read the AOA Health Policy Institute’s report on it.
Overall?
According to the report, the survey results indicate that patients benefit from ODs scope of expansion into providing in-office YAG.
The report added that MDs often require a consultation with the patient prior to scheduling the YAG procedure—even after an OD has already diagnosed and referred the patient for care. As such, this results in “multiple copays, visits and costs associated with time and travel,” the report stated.
What’s the bigger picture?
According to the AOA, the Health Resources and Services Administration has predicted a shortage of more than 6,000 ophthalmologists by 2025; in contrast, the number of ODs in the United States is projected to grow 1.4% annually.
Take home.
With an aging population and growing shortage of ophthalmologists in the country, ODs are in a unique position to “fill the gap for YAG surgery (and other ophthalmic procedures),” the report stated.
*Disclaimer: The information provided in this article does not and is not intended to constitute medical and/or legal advice; instead, all information, content, materials available herein are for general information purposes only.