Cataract surgery wait times down in Waterloo Region thanks to local partnership

Wait times for cataract surgeries in Waterloo Region are down, as more publicly-funded surgeries are being done in private clinics instead of hospitals.

It’s a partnership that began in May 2021, during the COVID-19 pandemic, and one that expanded once the province gave the greenlight to increase the number of procedures.

Cataract surgeries, that are not complicated, can be done 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 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 of the surgeons in our region, including myself, do surgeries at both [locations],” McAlister said.

Some patients prefer going to the private clinic, as they do not need an intravenous line and can eat breakfast before the procedure.

“They still get a little sedation, 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 overall maybe a little easier for patients.”

Vision Group Canada, which TLC Laser Eye Centre operates under, said in 2023 there were 2,686 publicly-funded cataract surgeries performed in Kitchener-Waterloo. This past January, they received approval and government funding via the Integrated Community Health Services Centres (ICHSC) to do another 2,600 procedures this year.

“It’s a benefit for our patients. The waitlists have come down quite dramatically,” said Dr. Jaspreet Reyat, another ophthalmologist who performs surgeries at both St. Mary’s Hospital and TLC.

Each surgeon has their own list of patients so wait times vary, but Reyat said his patients are now getting their cataract surgeries done within a couple of months, compared to the previous one to two year wait.

Reyat said the majority of cataract cases can be done in private clinics and moving the straightforward surgeries to TLC means there is more availability at the hospital to do more complicated procedures. Those could include someone that has waited too long, has pre-existing eye conditions or other medical conditions, injury or trauma.

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

Doctors are paid the same by OHIP, whether the surgery takes place in hospital or at TLC.

“There’s a lot of capacity in facilities where historically non-publicly-funded procedures were done,” Dr. Mark Cohen, the CEO of Vision Group Canada, said.

His hope is that soon there will be no wait times for cataract surgeries in Waterloo Region.

“It’s a very, very quick surgery and it’s life-changing. Patients come in not seeing well and… they walk out seeing well.”

Concerns about privatization

Not everyone, however, sees the partnership as a good thing.

“Privatization of our public hospital services, in our estimation, is a really bad idea,” said Jim Stewart, with the Waterloo Region Health Coalition.

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

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

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

“This is going to de-stabilize, basically take away our identity as Canadians, because we really value and cherish our compassionate public health care system, which isn’t driven by profit, isn’t driven by money. It’s driven by people’s need for health care as something we all believe in, and that’s being destroyed.”

Vision group responds to criticisms

Dr. Cohen said the partnership means TLC is essentially an extension of St. Mary’s General Hospital.

Another common criticism of cataract procedures done in private clinics is that they upsell expensive lenses that patients have to pay for out of pocket.

Cohen said some patients do opt to pay for specific lenses that eliminate the need for glasses, but that’s handled the same way it is for patients who have their cataract surgery in hospital.

“We charge the same fees as the hospital for the lenses,” Cohen explained. “That conversation happens with the doctor, their patients and in the doctor’s office.”

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

“We’re not taking staff away from the halls. We’re adding to the capacity in the community.”

“Thinking outside the box”

McAlister said the way the partnership between St. Mary’s and TLC developed is one of its strengths.

“I would say that is 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 it has sort of evolved from there.”

Reyat describes it as a creative approach.

“Critical health infrastructure like hospitals and ORs [operating rooms] aren't built overnight. And so you have to kind of think out of the box in something different to say, ‘hey, how can we use our existing resources to get these waitlist down?’ I think we've done that here in Kitchener-Waterloo with this collaboration.”

For more on local surgeons and their wait times, you can go to the Waterloo Regional Eye Program’s website.