Office-based intraocular surgery in Australia

Office-based intraocular surgery has been carried out for three years and over 1400 procedures have been performed. There have been no systemic complications or infections. The establishment of an office-based facility is a complex venture. Apart from medicolegal, ethical and financial considerations there are regulations relating to structural requirements, sterilisation of instruments, air-conditioning, electrical hazards and other technical matters. Office-based surgery is convenient for both the patient and the surgeon. The patient remains calm and relaxed from the time of initial counselling to the end of postoperative convalescence. We have borrowed systems used in the United States for management of ambulatory surgical patients, in particular the counselling techniques. This, in our opinion, has been a significant factor for calm relaxed surgery. Patient acceptance and preference for ambulatory surgery will ensure that it is here to stay. A case can be made out for an economic and ethical obligation for this form of surgery to be implemented on a more widespread basis. It is not, however, the universal solution to ocular surgery. There are still specific indications and contraindications, in terms of both the doctor and the patient. At a time when government involvement is being felt more and more in the practice of medicine, any proven alternative method of health care delivery, provided entirely by the private sector, must be worthy of serious consideration.