distinguishing advantage, says the company, is that in the event of a
posterior capsule rupture, the device can't fall into the vitreous cavity,
because it isn't placed completely inside the eye. Insertion and removal
take only a few seconds, says the company.
Pharmaceutical pupillary maintenance
On the pharmaceutical side, Omidria (Omeros) is a combination of
phenylephrine and ketorolac that can be added directly to the BSS solu-
tion. Unlike rings, this product doesn't depend on surgical skill, and
providers say it does a great job of continuously maintaining dilation as
you irrigate the eye. "It really works," says Glenn N. Pomerance, MD,
owner and medical director of Renaissance Surgery Center in
Chattanooga, Tenn., "especially in difficult cases, such as glaucoma, IFIS
and diabetes." Dr. Pomerance also likes the fact that Omidria is manu-
factured in a strictly regulated proprietary drug manufacturing facility
rather than a compounding lab.
The worry is the economics.
At $465 for a 4 mm vial, "It's
expensive," says Dr. Pomerance.
For most Medicare Part B cases
that's not a big concern at the
moment, since the cost is reim-
bursed by Medicare as a pass-
through (at least through the
end of this year). However,
patients on some Medicare
Advantage plans may not qualify
for the pass-through. When that
happens, surgery centers and
A P R I L 2 0 1 7 • O U T PA T I E N TS U R G E R Y. N E T • 1 1 1
• Omidria continuously promotes dilation as you irrigate
the eye, and its formulation includes ketorolac, which dra-
matically reduces post-op pain.
