WHO WE AREThe California Academy of Eye Physicians and Surgeons (CAEPS) is the only statewide organization representing California ophthalmologists and their patients. CAEPS' activities include public education about important eye health care concerns, legislative advocacy, interaction with third party payers about reimbursement and coverage issues, and continuing medical education for ophthalmologists and their staffs. 
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AB 2236 VETOEDAB 2236 passed the legislature at the very last minute of the legislative session by ONE vote (41 Aye, 39 No or Abstain).
It would have allowed optometrists to do eye surgery with lasers and scalpels, and corneal crosslinking with minimal training.
Thankfully the Governor had the wisdom to VETO the bill:
To the Members of the California State Assembly: I am returning Assembly Bill 2236 without my signature. This bill would authorize optometrists to perform ocular surgical procedures currently performed by ophthalmologists after completing specified education and training. I am not convinced that the education and training required is sufficient to prepare optometrists to perform the surgical procedures identified. This bill would allow optometrists to perform advanced surgical procedures with less than one year of training. In comparison, physicians who perform these procedures must complete at least a three year residency program. For this reason, I cannot sign this bill. Sincerely, Gavin Newsom
We are very grateful to the Governor for protecting patient safety.
BIOSIMILARS OFFER ADDITIONAL TREATMENT OPTIONS
According to the US Food and Drug Administration (FDA), "A biosimilar is a biological product that is highly similar to and has no clinically meaningful differences from an existing FDA-approved reference product."
Clinically "inactive" components -- such as stabilizers or buffers (chemicals that the biologic product is dissolved or suspended in, for example) are allowed to be different in the products as long as safety and efficacy are not impacted.
The FDA also indicates an "interchangeable" product is "expected to produce the same clinical result as the [biologic it is "similar" to] in any given patient," allowing it it to be "substituted for the reference product without the involvement of the prescriber.
The American Academy of Ophthalmology (AAO) has issued a statement regarding biosimilars for use in the treatment of eye disease. According to the AAO, and CAEPS concurs,
"Before a biosimilar is required to be used for treatment or included in a step therapy regimen, it should be FDA-approved for the [specific eye purpose]. Such a pathway ensures there is evidence of safety—including for any [inactive components] — and efficacy for its use in the eye." Short of that, "the treating ophthalmologist should review the published evidence of safety and effectiveness for any biosimilar proposed for treatment with each patient to determine if it is the best clinical option."
Patients are advised to discuss fully the risks and benefits of any treatment option so they can make an informed decision about their care.
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