In states where ODs can perform capsulotomies, 97% of patients reported satisfaction in the convenience of having the procedure done in an optometrist’s office.
In states where ODs can perform capsulotomies, 97% of patients reported satisfaction in the convenience of having the procedure done in an optometrist’s office. Click image to enlarge.

The safety of optometrists performing certain in-office laser procedures is actively being demonstrated by the 10 states and counting that now authorize this privilege. The direct benefits of an expanded practice scope are also evident, as illustrated by the results of a new survey conducted by the American Optometric Association Research & Information Committee (RIC). The survey found that, in states where ODs can perform capsulotomies after cataract surgery, doctors and their patients reported convenience, shorter wait times and cost savings.

The AOA RIC administered the survey in April to doctors in the following 10 states where ODs can perform capsulotomies (years indicate when such laws were passed): Alaska (2017), Arkansas (2019), Colorado (2022), Indiana (2015), Kentucky (2011), Louisiana (2014), Mississippi (2021), Oklahoma (1998), Virginia (2022) and Wyoming (2021). Of 5,645 invited doctors, 406 responded to the survey.

"More than half of doctors of optometry who responded (56%) reported providing YAG laser capsulotomies in their practices and an overwhelming majority (89%) have the availability to perform the procedures within a week,” the AOA reported in an article on its website. Conversely, respondents reported that only 9% of their patients were able to see an ophthalmologist within a week of cataract surgery.

The following data were also derived from the survey results, according to the AOA article:

  • 35% of necessary YAG procedures performed by ODs are done in-office on the same day.
  • 97% of responding ODs reported patient satisfaction with the convenience of having YAG performed in an optometrist’s office.
  • 95% reported satisfaction and value in the continuity of care resulting from YAG being performed by their optometrist.
  • 46% reported patient satisfaction with direct cost savings when YAG procedures are performed in their local doctor’s office.

The consensus is clear: When optometrists can perform YAG capsulotomies in-office, both ODs and their patients reap the benefits of convenience and efficiency. With an aging population and a growing shortage of ophthalmologists across the United States, allowing more optometrists to provide this necessary procedure to their patients may help reduce the looming burden on the healthcare system.

“The Health Resources and Services Administration predicts a shortage of more than 6,000 ophthalmologists by 2025,” the AOA cited in the article from a recent report by its Health Policy Institute (HPI). “The number of doctors of optometry, meanwhile, will remain steady; the optometric workforce is projected to grow 1.4% annually—that’s a rate greater than the US population.”

These survey results add to the stack of evidence that optometrists are a viable solution to the increasing demand for post-cataract care. “Patients should not have to delay their eyecare procedures or incur unnecessary costs for multiple visits or added travel when doctors of optometry are fully trained to perform these procedures,” the HPI report concluded. “Doctors of optometry are in a unique position to fill the gap for YAG surgery (and other ophthalmic procedures), as they are locally accessible to patients in 78% of all US counties and county-equivalents and 82% of counties or county-equivalents where most of the population is rural.”

YAG procedures by doctors of optometry, after cataract surgery, better for patients’ care and convenience. American Optometric Association. Published July 13, 2023. https://www.aoa.org/news/advocacy/state-advocacy/yag-procedures-by-doctors-of-optometry-after-cataract-surgery-better-for-patients-care-and-convenience-aoa-survey-says?sso=y. Accessed July 17, 2023.