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Surgery, ophthalmologists: “Reform Dm 70 penalizes us, at risk of sight-saving interventions”

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Ophthalmologists on a war footing. “The updating of ministerial decree 70 – which establishes the qualitative, structural, technological and quantitative standards relating to hospital care – risks further penalizing ophthalmology already considered by the National Health Service as an ‘elective’ specialty, therefore not a priority”. This is the alarm raised by Soi, the Italian Ophthalmological Society, during the 19th International Congress scheduled from today to 21 May in Rome. “With 650 thousand surgeries a year – recalls Matteo Piovella, president of Soi – cataract surgery is the surgery most performed in our country and which restores sight when there is an opacification of the lens. Today this operation has become a totally different intervention, which must be done with the support of the most advanced technology essential to obtain the best and safest results. We take note of the lack of assistance of the National Health Service, of the inability to update resources and technologies, but we report with alarm that all this falls on patients, because it prevents ophthalmologists from treating in the best and necessary way “. ‘In our NHS digital technologies adopted only for 4% of the necessary’ “Carrying out surgery with initial cataracts without the demanding visual penalties that prevent people from a safe and normal life – explains Piovella – reduces intraoperative complications to an exceptional 1% . The new outpatient organizational models specific to ophthalmology are not within the scope in the capacity and understanding of the NHS. Today we must be able to integrate new surgical techniques with new preoperative diagnostic technologies, together with the use of more advanced digital surgical devices, which have determined in the last 20 years an extraordinary improvement in the control of interventions and safety of execution, reducing, under ideal conditions, intraoperative complications at risk of loss of sight and making the intervention perceive as more reliable and safe supported by extraordinarily better results ” . “This is the normal consequence of the opportunity to implant advanced technology artificial lenses, capable of correcting vision defects and presbyopia. In practice – continues the number one of Soi – cataract patients who undergo surgery refractive surgery of the lens thanks to the implantation of these artificial crystallines they have the possibility to drive the car, watch television, use the computer, use the mobile phone, read a book or newspaper without using glasses. Yet in our NHS digital technologies are adopted only for 4% of the necessary – Piovella remarks – a shameful debacle for which someone should take responsibility, even admitting not being able to organize what is indispensable today. I believe that citizens should know that the level of low quality ophthalmology surgery currently provided in our country is the responsibility of a little-added bureaucrat ornate, lacking the necessary knowledge and insensitive to any solicitation “. ‘Reduced by 75% reimbursement for cataract surgery’ “Another priority – continues the president of the Italian Ophthalmological Society is the question of costs and reimbursements. The reimbursement foreseen for cataract surgery starting from the year 2000, for purely economic reasons, is was progressively reduced by 75%, going from 2,500 euros to less than 700 euros overall for each intervention. A further reduction of 20% is envisaged in the new outpatient rates. The spending cuts implemented have had even more penalizing effects on the adoption of the new technologies and the updating of the organizational model of cataract surgery, considering that modern technologies would require spending increases of 300% globally “. “Mathematically irreconcilable numbers – Piovella notes – with the aim of achieving the best care in cataract surgery, today, in fact, not provided in the NHS, but only at a private level for a fee by the citizen with or without insurance. For this reason, Soi, which I remember represents the 7 thousand Italian ophthalmologists, for 15 years has supported at a technical-scientific level the need to implement the reimbursements currently applied to cataract surgery by 1,000 euros, bringing them back to the total sum of 1,700 euros “. “The professionalism of ophthalmologists and their skills – warns the specialist – are the most precious asset we have as doctors, and it is essential to invest in them and protect them. We cannot act to the detriment of them, because it would affect the visual health of the Italians. Today we have much safer, much more efficient surgeries and we are able to return to see almost double the number of patients compared to years ago “.

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