Safety and Efficacy of Vitreoretinal Office-Based Surgery: A Case Series of 173 Procedures in an Office-Based Suite

Abstract

Purpose: To address the gap in safety and efficacy data for office-based vitreoretinal surgery by reporting outcomes from a significant case series performed in a specialized, independent, physician-owned office-based surgery suite. Methods: A retrospective, single-center case series of 173 consecutive vitreoretinal surgeries performed between January 1, 2025, and July 31, 2025, at the Center for Advanced Surgical Exploration in Erie, PA, a physician-owned, Joint Commission–accredited office-based surgery suite. Patient selection was restricted to American Society of Anesthesiologists systemic health classifications I and II. Procedures were conducted under minimal oral sedation and local anesthesia. Primary outcomes included rates of intraoperative and postoperative complications and hospital transfers. Results: A total of 173 patients (173 eyes) were included in the study. The procedural mix included rhegmatogenous retinal detachment repair (48/173, 27.7%), full-thickness macular hole repair (35/173, 20.2%), epiretinal membrane peel (58/173, 33.5%), and other complex procedures, including subretinal gene therapy administration with Port Delivery Platform implantation (32/173, 18.5%). No anesthesia-related complications or intraoperative events requiring hospital transfer occurred. The postoperative endophthalmitis rate was 0%. Other postoperative complications were observed at rates comparable to those reported for similar procedures in ambulatory surgery center settings. Conclusions: This series provides initial supporting evidence demonstrating that a carefully selected portfolio of complex vitreoretinal surgeries can be performed safely and effectively in a properly equipped and accredited office-based setting. With strict patient selection and anesthesia protocols, the office-based surgery model represents a viable evolution in the delivery of ophthalmic surgery.