{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:22:04Z","timestamp":1783038124372,"version":"3.54.6"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":53,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"NIH National Institute on Aging","award":["K07 AG066814"],"award-info":[{"award-number":["K07 AG066814"]}]},{"name":"NIH National Institute on Aging","award":["K23 AG072035"],"award-info":[{"award-number":["K23 AG072035"]}]},{"DOI":"10.13039\/100031461","name":"Department of Anesthesia and Perioperative Care, University of California, San Francisco","doi-asserted-by":"publisher","award":["Patricia Sander Award"],"award-info":[{"award-number":["Patricia Sander Award"]}],"id":[{"id":"10.13039\/100031461","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Perioper Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cataract surgery is one of the most common elective outpatient surgeries performed among older adults in the United States. Modern surgical technique makes cataract surgery a relatively quick, low-risk, minimally invasive outpatient procedure that can be performed solely under ophthalmologist-directed local or topical anesthesia. However, in the US, the procedure is routinely performed with additional monitoring and intravenous sedation administered by anesthesia-trained personnel. Given the procedure\u2019s safety profile, we sought to characterize ophthalmologists\u2019 perspectives on barriers preventing the adoption of more individualized approaches to cataract surgery sedation that do not automatically default to employing routine anesthesia care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study was conducted between December 2022 to January 2024. Using a semi-structured interview guide developed with the Consolidated Framework for Implementation Research (CFIR) framework, we completed interviews with ophthalmologists who performed cataract surgery with or without anesthesia care in hospital outpatient departments, ambulatory surgery centers, minor procedure rooms, and\/or office-based surgery suites across the United States. Data were analyzed using an inductive thematic analysis approach to uncover descriptive themes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We interviewed 19 ophthalmologists (5 women), including 6 who had experience routinely performing cataract surgery without anesthesia care. Three major themes emerged: (1) inertia, defined as the tendency to continue established practices that serve to maintain the status quo, (2) financial considerations, and (3) the interdependent relationship between ophthalmology and anesthesiology. While some participants supported a more selective approach to the use of anesthesia services, study participants identified multiple barriers to change, including difficulty overcoming the current inertia, decreased reimbursement for office-based surgery, and concerns about implications for patient safety without routine anesthesia involvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ophthalmologists identified multiple barriers to changing current anesthesia-led sedation models for cataract surgery. Our findings can help inform future efforts to better align anesthesia care with patient and procedural needs in an aging US population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13741-026-00697-y","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T03:34:28Z","timestamp":1778470468000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["\u201cJust the way we always did it\u201d: ophthalmologist perspectives on changing routine anesthesia care for cataract surgery in the United States"],"prefix":"10.1186","volume":"15","author":[{"given":"Nora","family":"Lyang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Schwartz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saras","family":"Ramanathan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neeti","family":"Parikh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"Lane-Fall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Dohan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine L.","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"697_CR1","unstructured":"Baker-Schena L. Office-based cataract surgery: questions and concerns. 2017. https:\/\/www.aao.org\/eyenet\/article\/office-based-cataract-surgery-questions-concerns."},{"key":"697_CR2","first-page":"65","volume":"1","author":"EA Balas","year":"2000","unstructured":"Balas EA, Boren SA. Managing clinical knowledge for health care improvement. Yearb Med Inform. 2000;1:65\u201370. (In eng).","journal-title":"Yearb Med Inform"},{"issue":"2","key":"697_CR3","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","volume":"3","author":"V Braun","year":"2006","unstructured":"Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77\u2013101. https:\/\/doi.org\/10.1191\/1478088706qp063oa.","journal-title":"Qual Res Psychol"},{"issue":"12","key":"697_CR4","doi-asserted-by":"publisher","first-page":"2367","DOI":"10.1016\/j.ophtha.2013.04.030","volume":"120","author":"GC Brown","year":"2013","unstructured":"Brown GC, Brown MM, Menezes A, Busbee BG, Lieske HB, Lieske PA. Cataract surgery cost utility revisited in 2012: a new economic paradigm. Ophthalmology. 2013;120(12):2367\u201376. https:\/\/doi.org\/10.1016\/j.ophtha.2013.04.030. (In eng).","journal-title":"Ophthalmology"},{"issue":"5","key":"697_CR5","doi-asserted-by":"publisher","first-page":"451","DOI":"10.3341\/kjo.2019.0064","volume":"33","author":"JK Chung","year":"2019","unstructured":"Chung JK, Lee HK, Kim MK, et al. Cataract surgery practices in the Republic of Korea: a survey of the Korean Society of Cataract and Refractive Surgery 2018. Korean J Ophthalmol. 2019;33(5):451. https:\/\/doi.org\/10.3341\/kjo.2019.0064.","journal-title":"Korean J Ophthalmol"},{"key":"697_CR6","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-022-01245-0","author":"LJ Damschroder","year":"2022","unstructured":"Damschroder LJ, Reardon CM, Widerquist MAO, Lowery J. The updated consolidated framework for implementation research based on user feedback. Implement Sci. 2022. https:\/\/doi.org\/10.1186\/s13012-022-01245-0.","journal-title":"Implement Sci"},{"issue":"5","key":"697_CR7","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1111\/j.1442-9071.2005.01063.x","volume":"33","author":"R Eichel","year":"2005","unstructured":"Eichel R, Goldberg I. Anaesthesia techniques for cataract surgery: a survey of delegates to the Congress of the International Council of Ophthalmology, 2002. 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All study participants electronically signed an informed consent to participate and be recorded. All methods were carried out in accordance with the consolidated criteria for reporting qualitative research (COREQ) guidelines and content analysis methodological orientation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"61"}}