Eyeworld

EW CATARACT 33 December 2016 which may increase to 12% within 3 years, among U.S. and international members. Among the respondents, 59% said it was not a financially viable option for their practice; 43% said there was not enough data to provide clinical benefits. "I actually like FLACS and think it is advantageous in some patients," Dr. Braga-Mele said. "However, right now, I think the cons outweigh the pros. … We need to lower the cost to ourselves and patients, we need better efficiencies, and we need a smaller size [laser] that fits in the OR." Richard Lindstrom, MD, ad- junct professor emeritus, University of Minnesota, Minneapolis, was an early adopter of FLACS, but he now stands on the con side. When his practice initially used it, there were eight cataract surgeons and about 8,000 cataract procedures a year, with a high use of premium technol- ogy. "Our experience as we mon- itored the outcomes was that we couldn't measure a benefit where we could look a patient in the eye and say this is worth [the extra cost]," he said. In contrast, Dr. Lindstrom feels there's a direct benefit with the use of toric IOLs and some other newer IOL innovations. The practice never actually bought a femtosecond laser and instead relied on the company Sightpath Medical (Bloomington, Minnesota) to provide roll-on/roll- off use. Dr. Lindstrom still thinks this is a feasible option for practices not ready to invest in buying a laser, but he wonders if not purchasing the laser may have affected the prac- tice's commitment to its use. Now, surgeons at Minnesota Eye Consultants only intermittently use the laser—about 5% of total cases— usually when a patient has heard about FLACS from other practices' marketing and they request it. One advantage with FLACS is in the creation of a corneal relaxing incision, Dr. Lindstrom said. How- ever, he sees these created less often and thinks that use of toric IOLs will overtake the need for such incisions. The practice's outcomes match what recent large analyses and reports have found regarding FLACS, that it is not superior to cataract surgery with phacoemulsification, Dr. Lindstrom said. The debate will continue. EW with Alcon, Abbott Medical Optics, and Bausch + Lomb (Bridgewater, New Jersey). Dr. Lindstrom has financial in- terests with Alcon and Bausch + Lomb. Contact information Braga-Mele: rbragamele@rogers.com Cionni: rcionni@theeyeinstitute.com Donnenfeld: ericdonnenfeld@gmail.com Lindstrom: rllindstrom@mneye.com 800 -225-1195 • www.katena.com • www.sensormedtech.com Exceptional optics • Anti-reflection coatings • Low distortion & high resolution • Superior small pupil performance Ergonomic, durable design • Lightweight construction • Silicone grip • Scratch-resistant diamond hard coating MKT-0100-06/2016 Diamond bi - aspheric lenses Over 20 years' time, technology has changed every thing — except your lenses... Until now. Editors' note: Drs. Braga-Mele and Cionni have financial interests with Alcon (Fort Worth, Texas) and Abbott Medical Optics (Abbott Park, Illinois). Dr. Donnenfeld has financial interests

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