Cataract surgery wait times in Waterloo region reduced thanks to local partnership

Cataract surgery wait times in Waterloo region reduced thanks to local partnership

Wait times for cataract surgery in Waterloo Region are shorter because more government-funded surgeries are performed in private clinics rather than hospitals.

It’s a partnership that began in May 2021, during the COVID-19 pandemic, and expanded after the province gave the green light to expand the number of procedures.

Cataract surgery, which is not complicated, can be performed at the Kitchener Waterloo TLC Laser Eye Centre.

Christiane Dijong had surgery on both her eyes at the clinic in June, a procedure that took just a few minutes.

“It went great,” she told CTV News shortly afterwards, adding that she felt nothing during the surgery and only saw bright lights.

She was cared for by Dr. Chryssa McAlister, who performs surgeries at both TLC and St. Mary’s General Hospital in Kitchener.

“All the surgeons in our region, including myself, perform surgeries at both (locations),” McAlister said.

Some patients prefer to go to the private clinic because they do not need an intravenous line and can have breakfast before the procedure.

“They still get a little bit of numbing, but it’s a little tablet that they put under their tongue instead of through the intravenous line,” McAlister explained. “And that probably makes it a little bit easier for patients overall.”

Vision Group Canada, under which TLC Laser Eye Center operates, said 2,686 publicly funded cataract surgeries were performed in Kitchener-Waterloo in 2023. Last January, they received approval and government funding through the Integrated Community Health Services Centers (ICHSC) to perform an additional 2,600 procedures this year.

“It’s a benefit to our patients. The waiting lists have gone down quite a bit,” said Dr. Jaspreet Reyat, another ophthalmologist who performs surgeries at both St. Mary’s Hospital and TLC.

Each surgeon has his own patient list, so waiting times vary. According to Reyat, his patients can now have their cataracts operated on within a few months, whereas before they had to wait one to two years.

Reyat said most cataract cases can be treated in private clinics and that moving the simple surgeries to TLC means there is more availability in the hospital to perform more complicated procedures. That could be someone who has waited too long, has pre-existing eye conditions or other medical conditions, injury or trauma.

“So it’s a benefit for the whole system,” Reyat added.

Physicians are paid the same by OHIP regardless of whether the surgery takes place in a hospital or at TLC.

“There is a lot of capacity in facilities where historically non-publicly funded procedures have been performed,” said Dr. Mark Cohen, CEO of Vision Group Canada.

He hopes that there will soon be no more waiting times for cataract surgery in the Waterloo region.

“It’s a very, very quick operation and it’s life-changing. Patients come in with bad vision and… they walk out with good vision.”

Concerns about privatization

However, not everyone sees the collaboration as a good thing.

“We believe that privatizing our public hospital services is a very bad idea,” said Jim Stewart of the Waterloo Region Health Coalition.

Instead of paying for surgeries performed in private clinics, Stewart would like to see the government provide more money so hospitals can expand their surgical capacity.

“This is not just a slippery slope. We are falling off a cliff here. This is a dire emergency for our public hospitals. If we don’t stop this privatization now, we will end up with American hospitals, American costs and American health insurance,” he said.

Stewart noted that the province has already announced a plan to eventually move more procedures, including hip and knee replacements, to private centers.

“This is going to destabilize us, in fact take away our identity as Canadians, because we really value and cherish our compassionate public health care system, which is not driven by profit, not by money. It is driven by people’s need for health care as something what we all believe in, and that’s being destroyed.”

Vision group responds to criticism

According to Dr. Cohen, the partnership means that TLC is essentially an extension of St. Mary’s General Hospital.

Another common criticism of cataract operations performed in private clinics is that they sell the patient expensive lenses that he/she has to pay for themselves.

Cohen said some patients choose to pay for specific lenses that eliminate the need for glasses, but that is done in the same way as patients who have their cataract surgery in the hospital.

“We charge the same fees for the lenses as the hospital,” Cohen explains. “That conversation takes place with the doctor, their patients and in the consulting room.”

Cohen added that they are not taking additional staff from hospitals to perform these surgeries, as TLC already has staff on staff for the other surgeries they perform at their facility. He said they also hire semi-retired nurses or nurses who no longer work at the hospital.

“We’re not taking staff away from the hallways. We’re increasing capacity in the community.”

“Thinking outside the box”

According to McAlister, the way the partnership between St. Mary’s and TLC has developed is one of its strengths.

“I would say that’s probably one of the keys to the success of our program, is that it’s always been done intentionally through a partnership with the hospital, trying to deal with the volumes, and it’s kind of evolved from there.”

Reyat describes it as a creative approach.

“Critical health care infrastructure like hospitals and operating rooms aren’t built overnight. And so you have to think outside the box a little bit and come up with something different to say, ‘Hey, how can we use our existing resources to reduce these waiting lists?’ I think we’ve done that here in Kitchener-Waterloo with this collaboration.”

For more information about local surgeons and their wait times, please visit the Waterloo Regional Eye Program website.