Dr. David Lane was invited to speak to ophthalmologists at this year’s Toronto Cataract Course, on Saturday, March 2nd, 2019.
The Toronto Cataract Course is Canada’s premiere cataract conference, with international speakers sharing ideas about modern cataract surgery.
Dr. Lane spoke about why he feels private centres are best suited to perform premium cataract surgery in Ontario. Dr. Lane divided his talk into 2 main sections…..Refractive Services, and Financial Responsibility.
Dr. Lane feels that private centres are best suited to provide high level refractive cataract surgery due to the level of technology offered only in this setting.
These include femtosecond laser assisted cataract surgery (for custom correction of small amounts of astigmatism, more accurate capsulotomies, lens fragmentation), and topography guided excimer laser (for correction of preoperative corneal abnormalities, and postoperative refractive touch ups).
Dr. Lane gave the example of a patient who was seen elsewhere, and told that she was not a candidate for a multifocal intraocular implant for cataract surgery due to the fact that she had an “irregular cornea”.
She was seen by Dr. Lane for a second opinion, who offered a custom laser treatment for her corneas, to make them a more regular shape. With this advanced custom laser treatment, she then became a candidate for a multifocal implant (she did not want to have to glasses after cataract surgery). These services cannot be offered at a public hospital.
Dr. Lane also talked about the limited resources of Ontario with regard to cataract surgery. Data from the Ontario Ministry of Health show that the percentage of the population over age 65 is growing; in other words, our population is aging.
This means that the demand for cataract surgery is increasing. Unfortunately however, the funding for cataract surgery in Ontario has remained unchanged over the past 5 years due to fiscal constraints. Ministry data also showed that there are approximately 100,000 cataract surgeries performed in Ontario per year.
This number has not changed over the past 5 years. However, the number of cataract surgeries performed in private centers in Ontario has increased about 40% over the last 5 years. Approximately 50,000 cataract surgeries were performed in private centers in Ontario last year.
Dr. Lane pointed out that most ophthalmologists are not aware of the true cost of cataract surgery in the public system.
Dr Lane however, is very aware of the true cost of cataract surgery due to the fact that he serves a community in Lindsay with lots of Mennonites.
The Mennonites do not pay personal tax, and therefore have to pay for their medical care. In the public system it will cost a Mennonite $2,100 to have standard cataract surgery with a monofocal implant in the public system.
If the Mennonite wishes to have their astigmatism corrected at the same time it would cost $2,650 per eye (this is using traditional ultrasound, not laser surgery).
Therefore, all of the Mennonites in Dr Lane's community come to his private centre (LASIK Cataract Centre) for their cataract surgery simply because they have access to advanced technology and it costs less than the public hospital.
The main point that Dr Lane was trying to make is that by correcting astigmatism and presbyopia with premium implants in a private centre, it actually costs the ministry far less money than performing similar advanced surgery within the public system.
This fact highlights what Dr Lane refers to as financial responsibility within the health system.
Furthermore, by performing advanced technology premium cataract surgery in a private centre, this frees up valuable limited resources in the public system for those who truly need access to this system. (Dr. Lane’s wait list used to be over 2 years in the public system, whereas now it is 2-3 months)