Implications of the presence of private equity in ophthalmology: an academic perspective
Purpose of review
Private equity acquisitions of ophthalmology private practices have been steadily increasing over the past decade with far-reaching implications. Ophthalmology departments at academic medical centers are not insulated from the impact of this trend.
Recent findings
The limited data on this subject in the ophthalmology literature identify the growing number of practice acquisitions. However, the lack of transparency obfuscates a clear understanding of the effect on patients and practice patterns.
Summary
Leaders at academic medical centers need to be aware of surrounding practice consolida...
Source: Current Opinion in Ophthalmology - August 9, 2022 Category: Opthalmology Tags: PRIVATE EQUITY: Edited by Christina Y. Weng and Jayanth Sridhar Source Type: research
Transitioning from a standalone practice to a private equity-partnered practice and impact on clinical operations
Purpose of review
Private equity has made significant inroads into the specialty of ophthalmology. The purpose of this review is to evaluate the effect of private equity on clinical operations in an ophthalmic practice.
Recent findings
Private equity had become an important source of capital and management expertise that has resulted in the consolidation of many ophthalmic practices as an alternative to working for a hospital system, insurance carrier, or independent private practice.
Summary
The recent growth of private equity presence in ophthalmology has resulted in significant changes in clinical oper...
Source: Current Opinion in Ophthalmology - August 9, 2022 Category: Opthalmology Tags: PRIVATE EQUITY: Edited by Christina Y. Weng and Jayanth Sridhar Source Type: research
Private equity ownership of ophthalmology practices: how does it impact clinical research?
Purpose of review
To explore the impact of private equity ownership of ophthalmology practices on the success of their clinical research programs.
Recent findings
Private equity partnership in the clinical research space has been steadily occurring over the past decades. In addition to contract research organizations, private equity groups have also consolidated multiple independent clinical research networks. By investing in an increasing number of retina practices, one private equity group is attempting to create a synergistic relationship between clinical practice and clinical research with the goal of suppor...
Source: Current Opinion in Ophthalmology - August 9, 2022 Category: Opthalmology Tags: PRIVATE EQUITY: Edited by Christina Y. Weng and Jayanth Sridhar Source Type: research
How private equity achieves return on investment in ophthalmology
Purpose of review
To review how private equity entities generate profit for investors and ophthalmologists.
Recent findings
There is a preponderance of private equity acquisitions and consolidation in ophthalmology. These private equity entities generate revenue by growth, profit improvement, and efficient use of capital structure. Physician partners sell their revenue and assets to a private equity entity while retaining a percentage of future profit. In general, a greater percentage going forward, will result in a smaller initial buyout. Partners typically receive payment in the form of cash and stock in the p...
Source: Current Opinion in Ophthalmology - August 9, 2022 Category: Opthalmology Tags: PRIVATE EQUITY: Edited by Christina Y. Weng and Jayanth Sridhar Source Type: research
Private equity in ophthalmology: lessons from other specialties
Purpose of review
In the absence of long-term data of the effects of private equity in ophthalmology, this article reviews the role of private equity in other medical specialties as a guide to the future for ophthalmology.
Recent findings
Across an array of medical specialties, including anesthesiology, dermatology, emergency medicine, ophthalmology/optometry, radiology, and urology, medical practices are being consolidated into a few larger platform groups. Although there has been a short-term financial success for both private equity firms and senior medical practice partners, there exists broad skepticism fro...
Source: Current Opinion in Ophthalmology - August 9, 2022 Category: Opthalmology Tags: PRIVATE EQUITY: Edited by Christina Y. Weng and Jayanth Sridhar Source Type: research
Driving forces and current trends in private equity acquisitions within ophthalmology
Purpose of review
Private equity investment in ophthalmology has dramatically increased over the past 20 years. Despite a massive influx in private equity investment in ophthalmology, little is known regarding if and how private equity investment might affect practice behavior. This review seeks to discuss why private equity investment may be expanding in ophthalmology and explore recent data on demographic and billing trends before and after private equity acquisition.
Recent findings
Recent publications have identified ophthalmology and optometry practices acquired by private equity from 2012 to 2021. Practi...
Source: Current Opinion in Ophthalmology - August 9, 2022 Category: Opthalmology Tags: PRIVATE EQUITY: Edited by Christina Y. Weng and Jayanth Sridhar Source Type: research
Private equity in ophthalmology: differences between present versus past
Purpose of review
The purpose of this review is to examine the differences between the current private equity model in ophthalmology practices and the failed physician practice management companies (PPMC) of the 1990s.
Recent findings
Over the past 5 years, there has been an accelerating expansion of private equity into ophthalmology. In 2022, there are approximately 1400 ophthalmologists affiliated with one of over 30 private equity-controlled entities and further growth appears likely. This contrasts with the PPMC era that had only a few hundred ophthalmologists across a handful of companies and collapsed wi...
Source: Current Opinion in Ophthalmology - August 9, 2022 Category: Opthalmology Tags: PRIVATE EQUITY: Edited by Christina Y. Weng and Jayanth Sridhar Source Type: research
Editorial: Private equity investment and ophthalmology: why the discussion matters
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - August 9, 2022 Category: Opthalmology Tags: PRIVATE EQUITY: Edited by Christina Y. Weng and Jayanth Sridhar Source Type: research
Editorial introductions
No abstract available (Source: Current Opinion in Ophthalmology)
Source: Current Opinion in Ophthalmology - August 9, 2022 Category: Opthalmology Tags: EDITORIAL INTRODUCTIONS Source Type: research
Management of endothelial disease without keratoplasty
Purpose of review
Currently, the most widely used treatment for endothelial disease is endothelial replacement via endothelial keratoplasty. Increasingly selective techniques have allowed for increased safety and faster visual recovery. However, alternative treatment options that are lower in cost, require less surgical expertise, and rely less on tissue availability are needed. This review discusses established and emerging therapies for endothelial disease without keratoplasty.
Recent findings
Regenerative therapies that have been successful include Descemet stripping only and Descemet membrane transplants. Rh...
Source: Current Opinion in Ophthalmology - July 1, 2022 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research
Descemet membrane endothelial keratoplasty in complex eyes
Purpose of review
To review the current literature on Descemet membrane endothelial keratoplasty (DMEK) in complex eyes.
Recent findings
DMEK surgery has become a standardized procedure in Fuchs endothelial dystrophy and simple bullous keratopathy. But eyes with more complex disease present unique intraoperative and postoperative challenges to the DMEK surgeon. Poor visualization during surgery, complex anterior segment anatomy, altered anterior chamber dynamics, glaucoma shunts, and congenital or iatrogenic missing or altered iris and lens make DMEK surgery extremely difficult to accomplish.
Summary
DMEK...
Source: Current Opinion in Ophthalmology - July 1, 2022 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research
Indications for keratoplasty in management of corneal ectasia
Purpose of review
The current review aims to describe recent advancements in treatment of corneal ectasias and its effect on indications for corneal transplantation.
Recent findings
The majority of patients affected by ectatic corneal disease use contact lenses to correct resulting astigmatism. Patients who are intolerant of contact lenses or cannot achieve acceptable vision through conservative measures could consider keratoplasty. However, continuing advancements in both nonsurgical and surgical treatments are either reducing or delaying the need for keratoplasty in patients affected by ectatic corneal disease...
Source: Current Opinion in Ophthalmology - July 1, 2022 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research
Effects of systemic targeted immunosuppressive therapy on ocular surface
Purpose of review
The purpose of this review is to give an overview of the corneal manifestations of targeted systemic immunotherapies and provide guidelines for management when applicable.
Recent findings
The advent of newer systemic immunosuppressive therapy has resulted in the need for more awareness of potential ocular side effects. Side effects can range from vortex keratopathy as seen with the tyrosine kinase inhibitors, to epithelial microcysts as reported in the use of cytarabine and belantamab mafodotin, spontaneous corneal perforations have been reported with programmed death 1 inhibitors, while eyelid...
Source: Current Opinion in Ophthalmology - July 1, 2022 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research
Role of therapeutic contact lenses in management of corneal disease
Purpose of review
The current review highlights areas of innovation and research in the use of contact lenses in the treatment of corneal ectasia and ocular surface disease.
Recent findings
A series of academic reports were published by a committee of experts reviewing evidence-based practice patterns of contact lens use. There continues to be active research in the use of contact lenses in the management of keratoconus, including mini-scleral lenses, custom impression-based scleral lenses and wavefront-guided scleral lenses. Recent reports on contact lenses for ocular surface disease were primarily reviews, ret...
Source: Current Opinion in Ophthalmology - July 1, 2022 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research
Impact of vaccination on keratoplasty
Purpose of review
Corneal graft rejection has been reported after coronavirus disease 2019 (COVID-19) vaccination. The purpose of this review is to evaluate the literature regarding corneal graft rejection after vaccination, including rejection rates and risk factors. We aim to create a framework to identify patients who are at higher risk for graft rejection and may warrant consideration of prophylactic interventions.
Recent findings
Graft rejection has been reported following administration of mRNA, viral vector, and inactivated whole-virion COVID-19 vaccines. Most cases had additional risk factors associated ...
Source: Current Opinion in Ophthalmology - July 1, 2022 Category: Opthalmology Tags: CORNEAL AND EXTERNAL DISORDERS: Edited by Shahzad I. Mian Source Type: research
