Eyeworld

67 EW FEATURE Dr. Greenwood has seen ad- ditional patient benefit from the anti-nausea effect of ondansetron. He also views as an advantage the melt's availability to be ordered in 503B, which allows bulk orders without the need for individual prescriptions. Limitations The melt's primary disadvantage, Mr. Bender said, is the difficulty to redose or supplement the sedation once the procedure is started. That concern was echoed by the surgeons. "The disadvantages are that there isn't a safety blanket of the IV in the hand, however, anesthetists and nurses are quite adept at giving an IV in the operating room if it's needed, which is rare," Dr. Berdahl said. The need to start an IV occurs in fewer than 1% of Dr. Berdahl's patients. The only time Dr. Greenwood supplements the melt with an IV is in his cataract plus DMEK cases because there is a chance such sur- geries will take a few extra minutes, and the IV allows the patient to get some additional anesthesia, if needed. About 5% of the patients get additional medications. "The times I don't use MKO Melt are when I am going to do a block for a PKP or other complex surgery," Dr. Greenwood said. "These patients have an IV for the block so we use traditional anesthetic." Mr. Bender said there is a learn- ing curve to using the MKO Melt. "Once practitioners get a good understanding of how patients respond to the dosing and timing of administration, supplementation with IV medications becomes rare," Mr. Bender said. Patient feedback A number of patients have sought out Dr. Berdahl's practice due to severe needle phobias and because they heard he offered cataract sur- gery without the need for an IV. "In general, patients enjoy it," Dr. Greenwood said. "They are com- fortable, relaxed, and don't recall much from the surgery. Among the few comments Dr. Greenwood has received is that some patients don't like the taste, but they much prefer that over insertion of an IV. "They enjoy not having the IV," Dr. Greenwood said. EW Editors' note: Mr. Bender and Dr. Berdahl have financial interests with Imprimis Pharmaceuticals. Dr. Green- wood has no financial interests related to his comments. Contact information Greenwood: michael.greenwood@vancethompsonvision. com Berdahl: john.berdahl@vancethompsonvision.com Bender: chris.bender@vancethompsonvision.com I N S T R U M E N T S | S I N G L E U S E | D R Y E Y E | B I O L O G I C S Look to Stephens For sterile tissue allografts. Stephens Instruments | 2500 Sandersville Rd | Lexington KY 40511 USA Toll Free ( USA ) 800.354.7848 | info@stephensinst.com | stephensinst.com © 2018 Stephens Instruments. All rights reserved. Distributed exclusively through Stephens Instruments Learn more at halograft.org Stephens Instruments is the exclusive distributor of Halo implant patch grafts. Packaged in our patented easy-peel packaging system for rapid introduction on to the sterile field, halo tissues require no rinsing or reconstitution. Halo sterile tissues are high-quality and backed by the superior service that Stephens is known for. Stephens – more than instruments. SCLERA CORNEA PERICARDIUM For more information visit us at AAO 2018 booth #3717

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