Wait times for cataract surgery in Waterloo Region are shorter thanks to local partnerships

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

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

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

Christiane Dijong underwent surgery on both eyes at the clinic in June. The procedure 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 a private clinic because they do not need an IV 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 Centre 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 Centres (ICHSC) to perform another 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 and waiting times therefore vary. According to Reyat, his patients can now have cataract surgery within a few months, while previously 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 to 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 think the privatization of 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.

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

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

“This will destabilize and essentially take away our identity as Canadians because we truly value and cherish our compassionate public health care system, which is not profit-driven and not money-driven. It’s driven by people’s need for healthcare, something we all believe in, and that’s being destroyed.”

Vision group responds to criticism

Dr. Cohen said the partnership means 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 handled the same way as for patients who have their cataract surgery in the hospital.

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

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

“We are not taking staff out of the hallways. We are 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, that it’s always been done intentionally through a partnership with the hospital, trying to deal with the volumes, and then it kind of evolves from there has evolved.”

Reyat describes it as a creative approach.

“Critical health infrastructure like hospitals and operating rooms (ORs) are not built overnight. So you have to think outside the box and do something different to say, ‘Hey, how can we use our existing resources to reduce these waiting lists? to lower?’ I think we’ve done that here in Kitchener-Waterloo with this partnership.”

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