OCT 2013

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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Page 37 of 134

October 2013 and in the time needed to perform the procedure. Characteristics of the different femtosecond laser platforms Each laser has certain characteristics that physicians find attractive. Additionally, depending on how long ago they were developed, many femtosecond laser systems have been improved from their original design. Dr. Uy said the Augmented Reality imaging system with the LENSAR laser "allows the surgeon unprecedented appreciation of the lens anatomy and nuclear density." This system gives information similar to what a neurosurgeon can see from a CT scan or MRI. He said the understanding of the lens makeup helps in choosing the best technique, like stop and chop, prechop or divide and conquer, for nuclear disassembly. It also helps to optimize the phaco machine settings. With the Victus laser, Dr. Chee said she likes the docking aspect the best. It is performed in two steps that use a patient interface and a suction clip, which "are among the smallest and easiest to apply, especially in eyes with small palpebral apertures." One aspect that is more difficult with the laser is that in corneal incisions, an additional step is needed, and this requires more planning before applying the laser and a hard-docking procedure. The LenSx system has been updated over the years, Dr. Serafano said. "The patient interface (PI) has changed from a rigid form to a SoftFit," he said. "Initially the IOP was raised significantly when the PI was docked onto the cornea," he said. "Now with the SoftFit the IOP is raised only 16 mm Hg." He said the reduction of the diameter of the PI from 23 mm to 19 mm has allowed LOOKING for easier docking for patients with smaller lid fissures. The visualization of the cornea and anterior capsule increased since the imaging is now in HD, and the laser is now faster. He also said "the choices of lens fragmentation patterns have increased." Dr. Serafano said one thing that requires attention is "the ergonomics of placing the patient under the laser requires a little effort, and the gurney has to be close to the laser, especially with a right eye." Dr. Rivera said his center is now using the Catalys laser only "because of its ability to make our cases smoother in the OR." The docking system uses a liquid optic interface, which means there is no corneal touch. "Besides complete patient comfort, the accuracy of this system, combined with the ultra-fast OCT and automatic recognition and placement of all treatment planes, leads to case-to-case consistency EW CATARACT 35 without any surprises," he said. "The ability of this platform to recognize lens tilt and automatically adjust for it in three dimensions is also phenomenal." He said there are rare issues with the Catalys, including some occasions when patients cannot tolerate the bed position or the docking. More than one? "The LENSAR machine is such an efficient machine that it can handle all the cases we throw at it," Dr. Uy said. Another unit is not necessary, unless another ambulatory surgery center were to be opened. "It is very ergonomic and has a small footprint," he said. It can be moved aside if more space is needed for other types of surgeries. Dr. Chee said if it was a plausible option, she would like to have a femtosecond laser for each of the nine operating rooms in the Singacontinued on page 38 BUSINESS FOR NEW OPPORTUNITIES? 34 AMERICANS OVER MILLION HAVE HEARING LOSS THEY WALK INTO YOUR PRACTICE EVERYDAY ADD A HEARING CENTER TO YOUR PRACTICE ICE Avada Vision & Hearing is a program designed to generate incremental sales and provide seamless integration with your practice. ce e. To learn more about adding a hearing center and the potential ntial ti l impact for your practice call us today! Visit the Us at nce re Confe AAO Orleans New H BOOT 1 1 # 24 1-888-982-8232 www.avada.com/vision Avada Hearing Care Partnering Vision & Hearing © 2013 Hearing Healthcare Management, Inc.

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