Eyeworld

EW FEATURE 114 New technology in cataract surgery • April 2016 "It's always important when you're doing something technical to get feedback," Dr. MacDonald said, indicating that she examines patients at 1 week and 1 month postop to see how close they are to what she predicted prior to surgery. The analysis at 1 week after surgery is important because if a toric lens is implanted, it should be adjusted as soon as possible if necessary. Insider tips One key tip that Dr. Wolsey offered was to be conscious of positioning. "Make sure that the patient is flat and well positioned," she said. Also, use a lid speculum that doesn't have a lot of pressure because there's some concern that the lid speculum could change astigmatism values, she added. The systems have improved, Dr. Wolsey said, so they'll tell you when you're getting a good reading. The ORA system will show a green light when the surgeon is getting a par- ticularly good reading. Dr. Wolsey often does 3 readings to make sure there is consistency in the values. Dr. Weinstock said that 1 of the biggest tips he can offer is to make sure to have the preoperative infor- mation available in the operating room. Know what the astigmatism values are and compare them to ORA readings, he said. Surgeons can fine-tune with the ORA, he said, but if it is way off, the surgeon may not have the eye filled up enough with balanced salt solution or viscoelastic to have the right pressure or the cornea surface may be dried out. By having preop- erative data available as a reference, surgeons can get a sense of how good the data is. "It takes time and experience using the machine and gaining confidence with it," Dr. Weinstock said. Other small actions can be helpful, such as keeping the cornea wet during surgery, and ensuring the patient isn't squeezing and the lid speculum isn't wedged into the eye. EW Editors' note: Dr. Wolsey has no finan- cial interests related to this article. Dr. MacDonald has financial interests with Alcon. Dr. Weinstock has financial in- terests with Alcon, Abbott Medical Op- tics (Abbott Park, Illinois), and Bausch + Lomb (Bridgewater, New Jersey). Contact information MacDonald: Susan.M.MacDonald@lahey.org Weinstock: rjweinstock@yahoo.com Wolsey: dwolsey@theeyeinstitute.com which is constantly improving the nomogram based on the data entered. "Surgeons can pull their numbers and see how well they're doing," she said. This can help sur- geons keep track of their cases, and they can compare outcomes with and without the ORA technology, Dr. Wolsey said. Dr. Weinstock said that he tracks all outcomes for patients receiving a refractive cataract package and looks at patient data for 1 month and 3 months postop. Looking for any outliers and constantly refining nomograms can be helpful in ob- taining better outcomes. If surgeons collect data and feed it back to the ORA system, it will do this for you and optimize the "surgeon factor," he said. medical record so the doctor has all the information stored in one area. "I think VERION could help optimize case results by allowing surgeons to analyze their data," she said. Following outcomes In terms of following up on out- comes, Dr. Wolsey said that she has all of her data in the ORA system, Using continued from page 113 Are you a fan of EyeWorld? Like us on Twitter at twitter.com/EWNews

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