EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/115557
Integrating the femto for cataract surgery into your practice by Michelle Dalton Contributing Writer Kevin M. Miller, MD Robert P. Rivera, MD Economics, logistics, patient considerations should all be weighed evenly before purchasing device, experts say T he cost of owning a femtosecond laser for cataract surgery goes beyond just purchasing the device, said Kevin M. Miller, MD, Kolokotrones Professor of Clinical Ophthalmology, Jules Stein Eye Institute, Los Angeles. Practices need to consider the service agreement, patient interface/procedure fees, power supplies to ensure uninterrupted power, software/hardware upgrades, and the geographic location of the laser (which may mean giving up an exam room or an OR). "Don't rush into making the decision," Dr. Miller said. "Prices are 14 William Soscia, MD dropping rapidly. Increasingly, there's more clarity on how to bill for the services. And that's going to continue to change for the next several years." Take the time to evaluate the device and "be convinced of the efficacy of the procedure," said Robert P. Rivera, MD, in private practice, Hoopes Vision, Draper, Utah. Early in the decision-making process the group had a "lack of confidence in our ability to deliver on our promise," but the quality of the current generation femtosecond lasers has completely overcome those initial worries. "Our cataract surgery patients are accepting the femto to the tune of about 60%," he said. "The patient is walking away with a much better and quicker recovery." According to Robert J. Weinstock, MD, in private practice, Eye Institute of West Florida, Largo, the center had the volume to support the purchase, but "it was a mul- Ophthalmology Business • April 2013 Robert J. Weinstock, MD tifactorial decision for us. We have three very busy cataract surgeons in our practice, and it's growing. Next, patients are coming in and expecting laser cataract surgery." Like any piece of equipment, these lasers may have glitches that prevent them from working properly, however, and surgeons need to consider that as well. "In today's world, you can't reschedule," he said. "It's unacceptable to your premium patients." The group chose to purchase a second machine, he added. Acknowledging the physical space constraints of an ambulatory surgery center (ASC) may limit some placement options, "if you have a higher volume practice, flow may end up being an issue," said William Soscia, MD, Center for Sight, Bradenton, Fla. His group took two full years before deciding on a laser, and evaluated everything from outright cost to marketing issues to physical constraints of the ASC.