APR 04, 2023
Question: A colleague, a high-volume cataract surgeon, performs posterior capsulotomies with the Nd:YAG laser within the first year of cataract surgery in almost all patients for whom she places a lens implant in the capsular bag. She uses 10-20 laser bursts in each eye at each session and has the patient return for a repeat session every 3-4 months. She has a Saturday clinic where she performs these procedures, and she charges patients on a per-visit basis. I don’t believe all these procedures are legitimate; she disagrees. Is this practice ethical or even legal?
Answer: Although YAG laser treatment of posterior capsule opacification is often necessary, your colleague is providing it in a manner that is inefficient, costly, and inconvenient for the patient. Typically, such laser treatments are completed in a single session to open an opacified posterior capsule. In addition, the fact that she performs YAG laser treatments on almost all of her postoperative cataract patients suggests an excessive use of the procedure, exploiting patients and payors. Since these treatments are not medically justifiable and do not serve the patient's interests, they likely violate three rules of the Code of Ethics: Rules 2. Informed Consent; 9. Medical and Surgical Procedures’, and 10. Procedures and Materials.
Learn more at aao.org/clinical-education/redmond-ethics-center.
To submit a question, contact the Ethics Committee at ethics@aao.org.