In-office ophthalmic procedures can increase patient comfort

Patients who underwent corneal transplantation reported being satisfied with their procedure when it was done in an office setting rather than a traditional operating room.

Of 354 patients who responded to a questionnaire 6 months postoperatively, overall patient experience was generally positive, Jack S. Parker, MD, PhD, told Ocular Surgery News.

“We saw no difference in outcomes, although there are probably unmeasured improvements,” Parker said. “That is to say, when we have the operating environment so close to the clinic with all of our imaging and other useful materials, we can evaluate the patients much more carefully than we could otherwise if we had to take them back and forth between the two facilities. It probably has improved outcomes. In terms of what we measure, patients do just as well with their transplants certainly when operated on in a clinic room when compared with a big operating environment.”

Jack S. Parker

Patient satisfaction, comfort

Parker and colleagues performed the procedures in a SurgiCube (SurgiCube International BV), a localized and filtered surgical environment that can be set up in an office to carry out minor surgeries and microsurgical procedures.

The survey evaluated patient experience with the corneal surgery and the operation unit on a scale of 1 to 5, with 5 being the greatest satisfaction. The most common procedure performed in the SurgiCube was Descemet’s membrane endothelial keratoplasty, with 310 patients undergoing the surgery.

Patients rated the general experience of the corneal operation with an average score of 4.4 and patient comfort with an average score of 4.1.

Less anxiety, expense

Preoperatively, 272 patients had undergone ocular surgery in an operating room and 82 patients had not.

“We were a little bit apprehensive when we first started using the SurgiCube because it’s so different from such a conventional operating environment. We were worried that the patient might not trust it or might be nervous about having a surgery in a nontraditional surgical setting, but everybody was really quite pleased and probably more comfortable in the usual clinic than they would have been in a hospital,” Parker said.

Patients who had undergone previous ocular surgery in an operating room rated their in-office procedures no less favorably than a conventional operating theater, he said.

Furthermore, there is less maintenance expense with a SurgiCube than for a traditional operating room, and the SurgiCube can be retrofitted into any office setting, Parker said.

“It just doesn’t seem to be obvious when you’re operating on small, delicate eyes that it would be necessary to use one of those large, conventional operating room theaters that you do for brain surgery or pelvic fracture surgery, that sort of thing. The SurgiCube not only seems to be a more reasonable option, but it can also theoretically provide superior results because the sterility is maintained by a ventilation system that is poised just above the operative site as opposed to 10 feet overhead filtering clean air over all sorts of nonsterile surfaces. I don’t think it’s just as good — I think it’s probably a better thing. If it were my eye being operated on, I would prefer to be operated on in a SurgiCube if everything else was equal,” Parker said. – by Robert Linnehan

Disclosure: Parker reports he is a consultant for DORC International/Dutch Ophthalmic USA.

Patients who underwent corneal transplantation reported being satisfied with their procedure when it was done in an office setting rather than a traditional operating room.

Of 354 patients who responded to a questionnaire 6 months postoperatively, overall patient experience was generally positive, Jack S. Parker, MD, PhD, told Ocular Surgery News.

“We saw no difference in outcomes, although there are probably unmeasured improvements,” Parker said. “That is to say, when we have the operating environment so close to the clinic with all of our imaging and other useful materials, we can evaluate the patients much more carefully than we could otherwise if we had to take them back and forth between the two facilities. It probably has improved outcomes. In terms of what we measure, patients do just as well with their transplants certainly when operated on in a clinic room when compared with a big operating environment.”

Jack S. Parker

Patient satisfaction, comfort

Parker and colleagues performed the procedures in a SurgiCube (SurgiCube International BV), a localized and filtered surgical environment that can be set up in an office to carry out minor surgeries and microsurgical procedures.

The survey evaluated patient experience with the corneal surgery and the operation unit on a scale of 1 to 5, with 5 being the greatest satisfaction. The most common procedure performed in the SurgiCube was Descemet’s membrane endothelial keratoplasty, with 310 patients undergoing the surgery.

Patients rated the general experience of the corneal operation with an average score of 4.4 and patient comfort with an average score of 4.1.

Less anxiety, expense

Preoperatively, 272 patients had undergone ocular surgery in an operating room and 82 patients had not.

“We were a little bit apprehensive when we first started using the SurgiCube because it’s so different from such a conventional operating environment. We were worried that the patient might not trust it or might be nervous about having a surgery in a nontraditional surgical setting, but everybody was really quite pleased and probably more comfortable in the usual clinic than they would have been in a hospital,” Parker said.

Patients who had undergone previous ocular surgery in an operating room rated their in-office procedures no less favorably than a conventional operating theater, he said.

Furthermore, there is less maintenance expense with a SurgiCube than for a traditional operating room, and the SurgiCube can be retrofitted into any office setting, Parker said.

“It just doesn’t seem to be obvious when you’re operating on small, delicate eyes that it would be necessary to use one of those large, conventional operating room theaters that you do for brain surgery or pelvic fracture surgery, that sort of thing. The SurgiCube not only seems to be a more reasonable option, but it can also theoretically provide superior results because the sterility is maintained by a ventilation system that is poised just above the operative site as opposed to 10 feet overhead filtering clean air over all sorts of nonsterile surfaces. I don’t think it’s just as good — I think it’s probably a better thing. If it were my eye being operated on, I would prefer to be operated on in a SurgiCube if everything else was equal,” Parker said. – by Robert Linnehan

Disclosure: Parker reports he is a consultant for DORC International/Dutch Ophthalmic USA.