Policyholder Services

Am I covered for performing bilateral same-day RLE or bilateral same-day phakic implant procedures?

Updated 10/2/2019

Yes. For patient safety and to minimize your liability exposure, OMIC recommends that insureds follow these risk management principles:

• Patients undergoing immediately sequential bilateral intraocular refractive surgery (ISBIRS) should be at low risk for surgical complications. Treatment of both eyes on the same day is not recommended for “complex” surgical cases, such as in patients with amblyopia, pseudoexfoliation syndrome, high hyperopes with axial length <20.0 mm, eyes with previous ocular trauma, or eyes with active macular SRNVM with leakage or significant diabetic retinopathy, or in patients at higher risk of infection, such as patients who are immunocompromised or have poorly controlled diabetes.
• ISBIRS is not recommended in patients for whom there is a greater than normal risk of having difficulties calculating or selecting the appropriate IOL power. These types of patients include those who have previously undergone refractive surgery (e.g., LASIK, PRK, CK, and RK), have significant corneal scarring or keratoconus, have extremely long or short axial lengths, or have conditions that make it difficult to cooperate for the Optical or Ultrasonic Biometry (e.g., nystagmus or dementia).
• Immediately sequential bilateral patients should read and sign the applicable Addendum for Bilateral Same Day Surgery developed by OMIC or an equivalent bilateral consent addendum.  Click here to access the Addendum for Bilateral Same Day Refractive Lens Exchange Surgery or here to access the Addendum for Bilateral Same Day Phakic Implant Surgery.
• The physician should develop and follow appropriate protocols to reduce the risks for right-left eye errors and errors in IOL insertion.
• There should be complete aseptic separation of the first and second eye surgeries, including use of separate instrument trays that have undergone separate sterilization cycles; complete, repeat surgical scrub and draping; and separate intraocular irrigating fluids and drops with different lot numbers.
• Antibiotics should be appropriately administered at sufficient dosages to reduce the risk of endophthalmitis. Consideration should be given to use of intracameral antibiotics, either in the irrigating solution or injected into the anterior chamber.
• Any complication with the first eye should be resolved before proceeding with surgery on the second eye.