EW CATARACT
39
January 2018
Contact information
MacDonald: susan.m.macdonald@lahey.org
Packard: eyequack@vossnet.co.uk
Packer: mark@markpackerconsulting.com
Wiley: kpiroch@clevelandeyeclinic.com
healing and a safer procedure with
fewer complications. I think doctors
will find surgical cases to be easier
and that they'll be more confident
when using the device. Thus, they
may choose to use it in all their pre-
mium cases. Some doctors may find
a use in all cases, if they're looking
to be more efficient or provide
improved visual recovery. There is a
disposable cost to this; however, it
can be offset by surgical efficiency
saving surgeon and staff time."
Susan MacDonald, MD,
Peabody, Massachusetts, is using
miLOOP in a new technique with a
4-mm scleral tunnel for global out-
reach. "It's easy to teach miLOOP to
surgeons who need cataract expe-
rience," she said. "I've designed a
new technique. Using the miLOOP,
I will divide the nucleus into two
to four pieces and twist my hand to
the right or left, which will help me
deliver the nucleus into the anterior
chamber. Then I will use a lens loop
to deliver the nucleus out of the
anterior chamber. Depending on
how many pieces I cut the nucleus
into, I'm able to reduce the size of
the small incision extracap incision
down to about 5 mm, which I think
is significant."
According to Dr. Packard, the
price for miLOOP will be about
$100. "It remains to be seen how
well the market will respond to this.
I suspect it will only be used in more
challenging hard nuclei," he said.
Learning curve
These devices eliminate the capsu-
lorhexis, which is the most difficult
part of cataract surgery, so the learn-
ing curve is not steep.
"One of the immediate markets
that I would be going after is the VA
because most of the cataract surgery
at the VA is done by residents," Dr.
Packer said. "They're early in their
learning curve, and they experi-
ence complications. Complications
cost time and money, and no one
likes that. I could see replacing the
capsulorhexis with a capsulotomy in
a context like that, where primar-
ily residents are doing the surgery.
When they graduate and go on to
practice, that's what they will use.
However, if you're really skilled in
performing a capsulorhexis, this
takes more time and costs more
money." EW
Editors' note: Dr. Packard has financial
interests with Excellens (Los Gatos,
California). Dr. Packer has financial
interests with ApertureCTC. Dr. Wiley
has financial interests with Iantech.
