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P
Some of the safety discussion involving OBS
revolves around sedation. When operating at
an ASC, Dr. Melendez said he had an anesthesi-
ologist and nurse anesthetist. About 20% of his
patients were receiving blocks and were heavily
sedated. When he first started his OBS, he
wasn't using IV sedation, but he was prepared
to do so if needed, with a nurse anesthetist on
staff. After a year of only using oral sedation,
he found he didn't need the nurse anesthetist.
"We still monitor the patient, even to this day,
because I think that's good medicine, and we
want to make sure everyone is healthy and safe.
… I still haven't done an IV [in my OBS]. I hav-
en't done a retrobulbar block. It's all been oral.
I haven't had one emergency yet, fortunately, so
it's been very safe and effective for me."
were consistently excellent, with a safety
profile expected of minimally invasive cataract
procedures performed in ASCs and HOPDs."
4
A retrospective study evaluating the rate of
adverse events after office-based lens surgery
performed at 36 private practices also found
the rate of adverse events in the OBS setting to
be more favorable than in an ASC setting.
5
Per
data presented at the 2025 ARVO Annual Meet-
ing of 656 cataract surgeries performed at an
OBS compared to 679 at an ASC, "office-based
settings may be associated with a significantly
lower rate of adverse events compared to ASC,"
according to the abstract.
6
"I've never had one infection in 5 years," Dr.
Melendez said. "And we've done nearly 5,000
surgeries."
continued on page 76
Office-based surgery centers
Source: iOR Partners
Relevant disclosures
Hovanesian: iOR Partners
Kugler: iOR partners
Loden: None
Melendez: Alcon,
Bausch + Lomb, Zeiss
