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O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E | A U G U S T 2 0 1 4
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or close to a decade, patients have been allowed to pay out
of pocket for such cataract surgery upgrades as toric and
presbyopic IOLs, astigmatism-correcting arcuate incisions,
intraoperative wavefront aberrometry and now laser
cataract surgery. To find out just how popular and prevalent
these out-of-pocket upgrades are, last month we surveyed 212 man-
agers at facilities that host cataract cases.
We found that premium services are becoming a bigger and bigger
part of cataract surgery. In the typical facility, from 11% to 20% of all
patients purchase at least one service out of pocket. Overall it's been a
positive trend: The outcomes are generally good, patients are general-
ly pleased and the upgrades are providing surgeons (although not
facilities) some extra profit.
The main problem: Many elderly cataract patients don't have the
money to pay for upgrades. As a result, facility managers expect only
moderate growth in these services — don't expect them to take
cataract surgery by storm anytime soon.
Gaining traction
Our survey respondents say premium cataract services have definitely
gained traction over the decade they've been available. The one that's
grown the most is correction of astigmatism, the decline in vision that
happens when the cornea is oblong rather than spherical.
The most popular way to attack astigmatism is via toric intraocular
lenses, designed to compensate for corneal astigmatism as well as
refractive error. In a typical facility doing cataract surgery, 11% to 20%
of all patients receive these lenses. "Our toric patients are routinely
ecstatic," says a facility manager.
A solid number of patients also receive arcuate corneal incisions,
incisions in the cornea itself aimed at altering the curvature to make it
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