Aa
Is it OK that I chose to have surgery by a different ophthalmologist?
I currently belong to an HMO and will soon have cataract surgery.The ophthalmologist that I was assigned is very nice but new there and young..maybe 40 or so.My eyes are more complicated than average in that I have severe myopia in both eyes (-5 and -9.25 diopters), early glaucoma, astigmatism and some other things.I chose to go with another eye doctor there that was recommended to me who has many years there and has done, I understand, over 5000 cataract operations.When I called to schedule my appointments, the woman I spoke there sounded upset that I didn't choose the doctor they assigned me..(who I will still be using as my eye doctor there but not for the surgery). I told her I preferred someone who was well versed in doing this surgery. By the way, the doctor I was assigned...himself...said that he could do the operation but that if it was his mother getting the operation...HE would pick the doctor I chose. Did I do the right thing?
You are the one getting the surgery so you need to be comfortable with the surgeon, it doesn't matter if any of the staff disapprove.
Although the odds are extremely high you will have a good result no matter what surgeon you use these days in a modern country, studies do show that experience does improve the results with cataract surgery, and high volume surgeons on average have better statistical complication rates than low volume surgeons. This study shows a lower complication rate among surgeons who do more than 1,000 surgeries per year:
http://www.escrs.org/PUBLICATIONS/EUROTIMES/07May/Lowcomplicationswith.pdf
I had seen another similar study sometimes in the past few months but a quick search doesn't seem to turn it up. Obviously skill plays a part also, but practice helps. In addition, fortunately complications are rare, but that means a low volume surgeon might encounter a complication they haven't seen before and not handle it as well as a surgeon that had dealt with it in the past. Again, I should emphasize that the statistical differences are minor, the odds are that you'll get great results whoever you go with. I just figure that if you have a choice, you may as well go with the best surgeon you can find. Obviously high volume surgeons are hard to find, though I would personally be cautious even about an older surgeon who had done 5,000 surgeries if for instance he'd been practicing 20 years which leads that to only be 250/year.
The surgeon I used in Europe had 40,000+ cataract surgeries, but that is atypically high. Since I was traveling to get surgery however I figured it was safest to get the best surgeon I could find even if the odds are it wouldn't make a difference (though partly since I did have a US surgeon claim that standards are higher here than in Europe). I suspect unfortunately that the number of surgeons in the US likely leads to fewer high volume surgeons.
Although the odds are extremely high you will have a good result no matter what surgeon you use these days in a modern country, studies do show that experience does improve the results with cataract surgery, and high volume surgeons on average have better statistical complication rates than low volume surgeons. This study shows a lower complication rate among surgeons who do more than 1,000 surgeries per year:
http://www.escrs.org/PUBLICATIONS/EUROTIMES/07May/Lowcomplicationswith.pdf
I had seen another similar study sometimes in the past few months but a quick search doesn't seem to turn it up. Obviously skill plays a part also, but practice helps. In addition, fortunately complications are rare, but that means a low volume surgeon might encounter a complication they haven't seen before and not handle it as well as a surgeon that had dealt with it in the past. Again, I should emphasize that the statistical differences are minor, the odds are that you'll get great results whoever you go with. I just figure that if you have a choice, you may as well go with the best surgeon you can find. Obviously high volume surgeons are hard to find, though I would personally be cautious even about an older surgeon who had done 5,000 surgeries if for instance he'd been practicing 20 years which leads that to only be 250/year.
The surgeon I used in Europe had 40,000+ cataract surgeries, but that is atypically high. Since I was traveling to get surgery however I figured it was safest to get the best surgeon I could find even if the odds are it wouldn't make a difference (though partly since I did have a US surgeon claim that standards are higher here than in Europe). I suspect unfortunately that the number of surgeons in the US likely leads to fewer high volume surgeons.
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