13 February 2024
Jag Singh, optometrist and head of clinical proposition at Newmedica, says...
Posterior Capsular Opacification (PCO) is caused by proliferation and inappropriate accumulation of lens epithelial cells (LECs) on the surfaces of intraocular lenses and the posterior lens capsule, leading to reduced visual acuity. This can happen after cataract lens surgery. Risk factors to the accumulation of LECs include conditions such as diabetes or previous eye inflammation, and age. The key factors that can help to reduce the likelihood of PCO include the health of the eye, quality of surgery carried out, and the type of lens used. YAG laser is normally used to correct the issue.
Newmedica, an independent ophthalmology provider, minimises these risk factors through a combination of exceptional clinical standards and by using a high quality monofocal lens as standard for all NHS patients. This is at no additional cost to the NHS. This lens is designed to reduce the risk of PCO, using a hydrophobic material and a proprietary edge design to slow the growth of LECs. A study by the Royal College of Ophthalmology (RCO) in 2021 showed that at three years, the overall PCO YAG treatment rate for Monofocal Single Piece IOLs was 7.4%, while the monofocal lens used by Newmedica has a rate of just 2.8%.
The report also found a clear distinction between hydrophobic and hydrophilic intraocular lenses and that the associated PCO YAG treatment rate for hydrophilic IOLs at three years was 14.9% – which was greater than five times higher than the associated rate for hydrophobic lenses.
To put these figures into context, it means over 46,000 YAG treatments have been avoided since Newmedica introduced the lens in 2017, saving the NHS over £4.5 million. This number is predicted to rise to over 168,000 YAG procedures and over £16 million by 2029, based on the volume of patients treated to date with the lens. This is clearly better for patients, and for the NHS as it eases financial and capacity pressures.
Local community optometrists have a professional relationship with those ophthalmologists and can put a face to the name
Supporting patient choice
Singh also spoke about the patient journey from community optometrists to cataract surgery, and how Newmedica works closely with optometrists to deliver patient care.
“As an optometrist, you are likely to have been seeing a patient for years for sight tests before spotting an eye condition like cataracts,” he said. “It may be that you’ll monitor that cataract for a number of months or even years before making the recommendation that the patient has it treated. That’s normally because the cataract is starting to have a growing impact on the patient’s ability to do the things they love or need to do.
“At that point, you have the conversation with the patient about cataract surgery, explaining the risks and benefits. Ultimately, it’s the patient’s choice whether they go ahead or not. If they decide to go ahead the optometrist needs to explain that the patient has a choice of where they have their treatment, which can be from an NHS hospital or an independent provider like Newmedica. They may also choose to go privately because they want a specific type of lens, for which Newmedica caters. Our research shows that most patients will look to their optometrist for advice and will value their recommendation.
“There are a number of factors that set Newmedica apart from other providers. The monofocal lens we use for NHS patients, as we’ve already been discussing, is a key one. We do that because we know it’s the right thing for patients as it provides the best clinical outcomes. We also know patients are anxious before treatment, and it’s important for them to feel relaxed for themselves and to ease surgery. We offer to hold their hand during surgery, introduce them to their surgeon on the day, and even choose the music they want played in theatre. These are just a few of the reasons why 99% of our patients would recommend Newmedica to their friends and family.
“Plus, because Newmedica sites are locally owned and led by our consultants, it’s very much a partnership approach. It means local community optometrists have a professional relationship with those ophthalmologists and can put a face to the name. If they have questions, they can run them past one of the consultant partners. That’s a more effective way of working for both optometrists and patients – it’s a real partnership in patient care.
“Depending on locally commissioned cataract services, the patient will return to the optometry practice from which they were referred, usually four weeks later to ensure the surgery has been a success. If there are no complications, a refraction assessment should be done to assess their vision and whether they need a new pair of glasses for example.
“The patient may be referred for cataract surgery on the second eye, if needed, usually at the same ophthalmology provider where their first eye was treated. If a service isn't commissioned locally, then Newmedica will see that patient for their post-operative care.”
For more information about how to refer patients to Newmedica, visit the how to refer page online.
