Eyeworld

W ith the introduction of any new tech- nology there are the accompanied new challenges. Femtosecond laser cataract surgery certainly is no excep- tion. Perhaps never in the history of anterior segment surgery has a new technology been more exciting or more controversial. Surgeons across the world are weighing the financial risks and potential benefits for their patients. At this time there is no definitive data that clearly shows that femtosecond (FS) cataract surgery is safer or more efficacious than traditional cataract surgery. Yet the potential benefits are significant. Therefore all surgeons are faced with numerous decisions: • Do I need to adopt this technology? • When do I purchase one? • Can I afford the laser? • How do I pay for it? • Which patients will benefit? • How do I charge patients? • Where do I place the laser? • How will the laser affect flow in the OR? • Which laser should I purchase? • Should I be an early adopter or should I wait until some of these issues are worked out? This issue of EyeWorld will help you better understand the rapidly chang- ing world of FS laser cataract surgery. We have asked several surgeons to help us answer these challenging issues and provide the most up to date informa- tion for you. We have a story on the status of each of the FS lasers and what differentiates these devices. Then, Robert J. Cionni, M.D., and Eric D. Donnenfeld, M.D., who are among the first surgeons in the U.S. to incorpo- rate the FS laser into their practices, discuss how they've handled the various obstacles and pitfalls they experienced. Richard J. Mackool, M.D., Stephen G. Slade, M.D., and Kerry D. Solomon, M.D., discuss perhaps the biggest fear surgeons have: Can I afford a FS laser? They present their views on the various business models and how they feel their practices will financially ap- proach this new technology. Another significant ongoing debate with the FS laser for cataract surgery is who is eligible and who can be charged, especially those patients with Medicare. Nancey McCann, Kevin J. Corcoran, William L. Rich III, M.D., and Michael X. Repka, M.D., stress the point that we cannot charge Medicare patients for a procedure already covered. Eric D. Donnenfeld, M.D., gives his views on this topic and weighs in on whether this can be viewed as a "refractive procedure." Not all surgeons see the benefit of the FS technology. Steven G. Safran, M.D., Brad Oren, M.D., D. Brian Kim, M.D., and Gary Wortz, M.D., pro- vide opposing viewpoints to the advantages of the FS laser in cataract sur- gery. They argue that this technology does not result in a better cataract procedure and explain why, at this point, they are not planning on purchas- ing one. Another key issue with FS laser cataract surgery is the ethics surrounding this new technology. John Banja, Ph.D. and Rich Hoffman, M.D. discuss the host of potential conflicts that surgeons must deal with when recommend- ing the FS laser over traditional cataract surgery. At this time no one can say with certainty how the FS laser will change cataract surgery. One thing is for certain: EyeWorld and ASCRS are dedicated to providing the most current and balanced information on FS lasers. We want to assist members in your decision-making and help answer if, when, and how the FS laser should be incorporated into your practices. Edward J. Holland, M.D. President, ASCRS Publisher Donald R. Long dlong@eyeworld.org Editorial Editor Stephanie Graham stephanie@eyeworld.org Assistant Editor Stacy Majewicz smajewicz@eyeworld.org EyeWorld Staff Writers Faith Hayden faith@eyeworld.org Jena Passut jena@eyeworld.org Production Graphic Designer Julio Guerrero jguerrero@eyeworld.org Production Manager Cathy Stern cstern@eyeworld.org 703-383-5702 Production Assistant Karen Salerni ksalerni@eyeworld.org Contributing Editors Vanessa Caceres Lakeland, Florida Michelle Dalton Reading, Pennsylvania Rich Daly Arlington, Virginia Enette Ngoei Singapore Matt Young Malaysia Senior Contributing Editor Maxine Lipner Nyack, New York Advertising Sales ASCRSMedia 4000 Legato Road Suite 700 Fairfax, VA 22033 703-591-2220 fax: 703-591-0614 eyeworld@eyeworld.org www.eyeworld.org Advertising Sales Managers Jeff Brownstein jbrownstein@eyeworld.org 703-788-5745 Paul Zelin pzelin@eyeworld.org 703-383-5729 Classified Sales Cathy Stern cstern@eyeworld.org 703-383-5702 EyeWorld Special Projects and Events Jessica Donohoe jdonohoe@eyeworld.org 703-591-2220 ASCRS Publisher: EYEWORLD (ISSN 1089-0084) is published monthly by ASCRS Ophthalmic Services Corp., 4000 Legato Road, Suite 700, Fairfax, VA 22033-4003; telephone: 703-591-2220; fax: 703-591-0614. Printed in the U.S. Editorial Offices: EYEWORLDNews Service, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4003; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: eyeworld@eyeworld.org. Advertising Offices: ASCRSMedia, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4003; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: eyeworld@eyeworld.org. Copyright 2011, ASCRS Ophthalmic Services Corp., 4000 Legato Road, Suite 700, Fairfax, VA 22033-4003. All rights reserved. No part of this publication may be reproduced without written permission from the publisher. Letters to the editor and other unsolicited material are assumed intended for publication and are subject to editorial review and acceptance. Subscriptions: Requests should be addressed to the publisher. Annual subscription prices: Individual: 1 year, $120; 2 years, $220; 3 years, $320. Institutional: 1 year, $250; 2 years, $330; 3 years, $425. Foreign: 1 year, $240, 2 years $470, 3 years, $700. Back copies: Subject to availability. Contact the publisher. Cost per copy is $15; $30 foreign. All orders for individual or back copies must be accompanied by payment. Requests to reprint, use, or republish: Requests to reprint or use material published herein should be made in writing only to Cathy Stern, EYEWORLD, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4003; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: eyeworld@eyeworld.org. EYEWORLD reprints: To order reprints of material published in EYEWORLD, contact Cathy Stern, EYEWORLD, 4000 Legato Road, Suite 700, Fairfax, VA 22033-4003; toll-free: 800-451-1339, 703-591-2220; fax: 703-591-0614; email: cstern@eyeworld.org or your salesperson. Change of address: Notice should be sent to the publisher six weeks in advance of effective date. Include old and new addresses and label from recent issue. The publisher cannot accept responsibility for undelivered copies. POSTMASTER: Send change of address to EYEWORLD, 4000 Legato Road, Suite 700, Fairfax, VA 22033. Periodical postage paid at Fairfax, VA 22033 and at additional mailing offices. The ideas and opinions expressed in EYEWORLDdo not necessarily reflect those of the editors, publisher, or its advertisers. P U B L I S H I N G   S T A F F July 2011 Volume 16 • No. 7 A S C R S The official publication of the American Society of Cataract & Refractive Surgery The next frontier in cataract surgery Edward J. Holland, M.D. cornea editor

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