FRANKFORT — Over the strong objections of ophthalmologists and the Kentucky Medical Association, a state legislative panel approved regulations Tuesday giving optometrists the ability to perform limited eye surgery using lasers.
The controversial measure now goes to another legislative committee before going to the governor for final approval. But opponents said after Tuesday's meeting of the Administrative Regulation Review Subcommittee that they might file legal action against the Kentucky Board of Optometric Examiners, which drafted the regulations, for failing to comply with the state's Open Meetings Act.
The legislature passed Senate Bill 110 earlier this year, granting optometrists — who do not attend medical school but have four years of advanced training — the ability to perform eye surgeries using lasers, scalpels, needles, ultrasound, ionizing radiation and tools that burn and freeze tissue.
The bill — which went through the legislature in 12 days — had widespread support from legislators despite objections from doctors who said the state was giving surgical privileges to people who have not been to medical school.
Ophthalmologists told the Administrative Regulation Review Subcommittee on Tuesday that the Kentucky Board of Optometric Examiners used a task force appointed by the state optometrist association, a trade group, to develop the regulations, and those meetings were held in secret with no public input.
Opponents asked that the committee to send the regulations back to the Kentucky Board of Optometric Examiners for further review.
But many legislators and optometrists said that the public was allowed to comment on the regulations at an open meeting in July and that the board made changes to the regulations after receiving public comment.
Rep. Johnny Bell, D-Glasgow, and co-chairman of the Administrative Regulation Review Subcommittee, said he did not see where the committee or the board violated Kentucky statutes that deal with regulations.
Dr. Woodford Van Meter, president of the Kentucky Academy of Eye Physicians and Surgeons, said the regulations — which require 32 hours of training before an optometrist is allowed to use lasers in surgery — do not go far enough to protect patient safety.
According to the regulations, an optometrist must show proficiency on one human eye. Van Meter asked the committee to compare those requirements to ophthalmologists, who have 17,000 hours of surgical training and have to perform various surgeries hundreds of times under the supervision of an instructor before being allowed to perform the operation on their own.
"It is a disservice to the people of Kentucky," Van Meter said. "What happened to patient safety?"
Optometrists counter that doctors and dentists are not required to show any proficiency or be certified when new technologies and procedures are introduced.
Ben Gaddie, an optometrist in Louisville, said the task force had five medical doctors on it who helped develop the regulations. Optometrists have four years of advanced training in addition to the 32 hours required under the regulations, Gaddie said.
Sen. Joe Bowen, R-Owensboro, asked the Kentucky Board of Optometric Examiners twice to table the regulation until a later meeting because of the concerns raised by the medical community. But Jerald Combs, president of the board, declined to withdraw the regulation.
Gaddie said it's possible that optometrists would be able to perform the surgeries by the end of the year.
Oklahoma is the only other state that allows optometrists to perform laser surgeries.