Dear Editor

I read with interest the editorial by Dr DF Chang on SBCS and find myself in agreement with many of his points raised. A note of caution however. Several years ago when I had converted to topical clear cornea phako I started to perform SBCS on patients I felt required this and were suitable. As I saw the benefits for both the patients and the staff I decided to extend this to the majority of my patients. I was quickly stopped in my tracks when we discovered that SBCS is classified and reimbursed to our NHS hospital as a single procedure.

This is even if the patients is listed as two separate procedures. Our hospital could obviously not afford to "reduce" my operating list from 10 cataracts to 5 and at the same time use 10 sets of equipment and 10 IOLs etc every list. Therefore in the NHS one would have to very careful before embarking on SBCS until the purchasers or PCGT or whatever they will become in Foundation Status agree that it is more than a single procedure. I know DF Chang is relating his practice in the USA but after all the BJO is mainly about the practice of Ophthalmology this side of the Pond!