Department of Ophthalmology
and Vision Science
655 N. Alvernon Way, Suite 108
Tucson, AZ 85711-1824
Tel: (520) 321-3677
Fax: (520) 321-3665
www.eyes.arizona.edu
March 20, 2015
Re:
Affordable Choice Cataract Surgery Program
Dear Colleague:
I would like to let you know about a new research program at the University of Arizona Department of Ophthalmology
and Vision Science. This program is designed to study the costs and effectiveness of an alternative form of cataract
surgery (Manual Small Incision Cataract Surgery) that offers significant cost savings compared to Phacoemulsification
Cataract Surgery. We believe that by offering Manual Small Incision Cataract Surgery (MSICS) as an option to patients,
they may find that they can afford cataract surgery when they might not otherwise be able to, perhaps because of a lack
of insurance.
MSICS uses a small incision (6 mm), a silicon intraocular lens, and often is performed without stitches. Since incision is
larger than Phacoemulsification (typically a 3 mm incision) it is more likely that post-operative astigmatism requiring
distance correction will occur. This is likely to be the biggest difference in the long term between Phacoemulsification
and MSICS. Due to the larger incision with MSICS, the period of discomfort after the surgery is longer (perhaps a day
more than Phaco).
The cost to participate in this research program is $500 per eye (only one eye at a time). The eligibility requirements
are:
 Patients must be adults (over 21) and fully capable of giving informed consent.
 Patients must have visually significant cataracts (with acuity decreasing to 20/80 or worse in the presence or absence
of glare).
 Patient must not have any other coexisting eye disease that would be expected to limit the post-operative acuity.
Thus, patients selected must be reasonably expected to improve their vision to 20/40 or better after the surgery.
Participation is limited to referral by an optometrist or ophthalmologist who believes that the patient meets these
criteria and would likely benefit from surgery. After the surgery is complete, they will be referred back to you for final
prescription of eyeglasses.
A brief referral form is attached. If you have questions, please contact me directly at 520-661-6524. Please have the
patients call the same number (my cell phone) with a person who speaks English, and I will tell them more about the
program.
Thank you for your consideration.
Sincerely,
Joseph M. Miller, MD, MPH
Professor and Head
Enclosure
Affordable Choice Cataract Surgery Program Referral
Manual Small Incision Cataract Surgery
Patient Name _________________________________________
Date of Birth ___________________________________________
Primary Phone Contact _____________________________________
Secondary Phone Contact __________________________________
Spanish Only?
Yes


No
Does patient have visually significant cataract (with acuity decreasing to 20/80 or worse in the presence
or absence of glare)?
Yes 
No 
Does patient have any coexisting eye disease in either eye that would prevent them from
seeing 20/40 or better after the surgery?
Yes

No

TO BE COMPLETED BY REFERRING OPTOMETRIST OR OPHTHALMOLOGIST
Please evaluate the above named patient for participation in the Manual Small Incision Cataract Surgery
Program. I have examined the patient and believe that there is visually significant cataract that is
impairing their enjoyment of life, and that the acuity in the involved eye is 20/80 or worse due to the
cataract. I also expect that after cataract surgery there are no pre-existing problems that would
prevent them from seeing 20/40 or better in either eye after surgical correction and with eyeglasses.
(No monocular patients). The patient will be returned to my care following the surgery for final
eyeglass dispensing.
_________________________________________________________
Signature
Optometrist/Ophthalmologist
____________________________
Date
_______________________________
Office Number
FAX THIS FORM TO 694-1425 OR EMAIL PHOTO TO SueAnn.Bulau@bannerhealth.com