Section 12 AAC 48.040 - Expanded therapeutic procedure(a) A licensee may not perform ophthalmic surgery as defined in AS 08.72.278(c), unless the procedure is an expanded therapeutic procedure as defined under this section and the licensee is authorized by the board to perform the procedure.(b) The board may authorize a qualified licensee to perform an expanded therapeutic procedure or procedures in the practice of optometry. A licensee requesting authorization to perform an expanded therapeutic procedure shall have satisfactorily completed a course in the expanded therapeutic procedure provided by an institution accredited by the Council for Higher Education Accreditation and approved by the board, and shall further satisfy the requirements of this section.(c) The board may authorize a licensee to perform an expanded therapeutic procedure if the licensee provides: (1) proof of a current license in good standing to practice optometry in this state; and (2) evidence satisfactory to the board that the licensee successfully completed a course of instruction in an expanded therapeutic procedure approved by the board.(d) To be approved by the board, a course in an expanded therapeutic procedure shall include: (1) didactic classroom instruction in (A) laser physics, hazards, and safety;(B) biophysics of lasers; (C) laser application on clinical optometry; (D) laser tissue interactions; (E) laser indications, contraindication, and potential complications; (G) laser therapy for open angle glaucoma;(H) laser therapy for angle closure glaucoma;(I) laser posterior capsulotomy;(J) common complications of the lids, lashes, and the lacrimal system;(L) medicolegal aspects of anterior segment procedures; (M) peripheral iridotomy;(N) laser trabeculoplasty;(O) minor surgical procedures; (P) In overview of surgical instruments, asepsis, and Occupational Safety and Health Administration regulations; (Q) surgical anatomy of the eyelids; (R) emergency surgical procedures;(S) chalazion management; (T) epiluminescence microscopy; (U) local anesthesia techniques and complications;(V) anaphylaxis and other office emergencies;(W) radiofrequency surgery; and (X) post-operative wound care;(2) clinical or laboratory experience incorperating (B) in vitro observation or participation; and (3) passage of a formal clinical or laboratory practical examination; and (4) passage of a written test administered by the educational institution providing the course, that uses the National Board of Examiners in Optometry format.(e) A course of instruction maybe considered for approval by the board if the course;(1) meets the requirements of (d) of this section;(2) is provided by an accredited optometry school under (b) of this section; (3) is at least 32 clock hours in length;(4) is completed after graduation from optometry school; and(5) is completed after January 1,2016. (f) The bond may consider a course of instruction For applied if the course satisfies the requirements of (e)(1) through (e)(4) of this section, but was completed before January 1, 2016, if the licensee (1) has been practicing in a state that allows expanded therapeutic procedures immediately preceding the date of request for authorization of expanded therapeutic procedures; (2) has continuously practiced in that state from the time of completion of the approved course; and(3) provides an affidavit verifying a minimum of 1,040 hours of active clinical practice in optometry for each year since the date of completion of the approved course.(g) An optometrist licensed and authorized by the board to perform an expanded therapeutic procedure in the practice of optometry shall be limited within the scope of the boards authorization under (b) of this section. A license issued to the licensee must expressly identify each approved approved expanded therapeutic procedure the licensee is authorized to perform.(h) Notwithstanding any other provision of this section, a licensee may not perform ophthalmic surgery for the following procedures, but may provide preoperative and postoperative care for (1) retina laser procedures;(2) laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK); (3) surgery related to removal of the eye from a living human being;(4) surgery requiring full thickness incision or excision of the cornea or sclera other than paracentesis in an emergency situation requiring immediate reduction of the intraocular pressure;(5) penetrating keratoplasty/or lamellar keratoplasty;(6) non-laser surgery requiring incision of the iris and ciliary body, including iris diathermy or cryotherapy;(7) non-laser surgery requiring incision of the vitreous; (8) surgery requiring incision of the retina; (9) surgical extraction of the crystalline lens; (10) surgical implantation of intraocular lens implants;(11) incisional or excisional surgery of the extraocular muscles;(12) non-laser surgery of the eyelid for eyelid malignancies or for incisional cosmetic or mechanical repair of blepharochalasis, ptosis, and tarsorrhaphy; (13) surgery of the bony orbit, including orbital implants; (14) incisional or excisional non-laser surgery of the lacrimal system other than lacrimal probing or related procedures;(15) surgery requiring full thickness conjunctivoplasty with graft or flap;(16) any non-laser surgical procedure that does not provide for the correction and relief of ocular or ocular adnexa abnormalities;(17) injection into the posterior chamber of the eye to treat any macular or retinal disease(i) A licensee trating a patient with an eyelid or adnexal lesion found to be malignant shall refer the patient to a practitioner trained and qualified to treat those lesions.(j) A licensee may not perform an injection to the posterior segment or chamber, or retinal tissue to treat any macular or retina disease.(k) A licensee who performs an expanded therapeutic procedure without board authorization may be subject to disciplinary sanctions under AS 08.72.240.(l) For the purpose of section expanded therapeutic procedure" means an ophthalmic surgery approved by the board in compliance with AS 08.72.278, and may include anterior segment laser procedures, anterior segment surgical procedures, YAG laser capsulotomy, laser peripheral iridotomy, and laser trabeculoplasty.Eff. 12/8/2019, Register 232, January 2020Authority:
AS 08.72..050
AS 08.72.273
AS 08.72.278