by Paul Batson, O.D. Center Director VisionAmerica of Birmingham On September 19, 2017, Glenn Chin, the former supervisory pharmacist at the now-closed New England Compounding Center, entered a Boston, Mass. courtroom to be tried for second degree murder and mail fraud for his role in the 2012 fungal meningitis outbreak which affected over 800 people and resulted in the death of 76. (For more information on the on-going trial, click here.) As healthcare professionals, we often examine ourselves, along with the procedures and processes we have in place within our practices, to determine whether or not we are truly providing the best quality care to our patients. With this recent reminder in the news, we thought we would reflect on and share the reasoning behind some of the decisions we have made at VisionAmerica. Over the past year or so, there have been many discussions and a "push" for improving compliance, convenience and saving money for perioperative medications for cataract surgery.
Transzonular intravitreal medications that allow for a "no drop" or "dropless" surgery is a great goal but we've been hesitant to adopt this approach for several reasons. Having seen the effects of endophthalmitis, as well as Toxic Anterior Segment Syndrome years back, we felt (and still feel) that using a topical compounded drug provides a great alternative. As such, for the past year, we've been using a combination antibiotic, steroid, NSAID in one drop which provides the convenience while decreasing potential safety concerns of intraocular injections. Unfortunately, our concerns have come true in Texas where there has been an outbreak of Toxic Posterior Segment Syndrome. See the correspondence below from the American Society of Cataract and Refractive Surgery here. In addition, the FDA just released a warning of Hemorrhagic Occlusive Retinal Vasculitis (HORV) Following Intraocular Injections of a Compounded Triamcinolone, Moxifloxacin, and Vancomycin Formulation. Click here for more information. Our goal in caring for your patients is always safety, efficacy, cost, and convenience (in that order). As a result, for the foreseeable future, we will continue to offer "Less Drops" cataract surgery but will not be providing "Drop Less" or "No Drop" surgery. If you have any questions or concerns, please don't hesitate to contact us.
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AuthorThe staff and doctors at VisionAmerica are committed to providing relevant information for you, your patients and your practice. We hope you find the information in our blog post helpful. Archives
August 2019
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