Are you using the right Ophthalmic Microscope?

Technology does make a difference.

Today’s Ophthalmic market offers outstanding options in regards to microscopes. Just like the phaco market, Microscopes have adapted new advanced technologies in the last 10 years that far outweigh the years before.

We’ve encountered many different personality types in our surgeons. Some prefer to use what’s comfortable to them, regardless of how old the microscope may be. Some prefer to incorporate the latest technology into their surgical process as soon as it hits the market. Truth is,  we work with some incredibly skilled surgeons! But regardless of skill level, we’ve come to an understanding that surgical microscopes and the technology onboard DO play a big role in the surgeon’s comfort level and success during surgery. And that’s really what it comes down to, the surgeon’s comfort. However, regardless of how comfortable a surgeon may be with old technology, we believe that the new technology available today can help the surgeon achieve better results if they are willing to give it a try.

Our continued hope is to be a resource of knowledge to you as you grow your cataract business. So, in this article, we want to discuss some of the benefits onboard newer microscope technology.

What benefits do new Ophthalmic Microscopes provide?

1) Red Reflex & Illumination

In case you are reading this and are unaware of what Red Reflex is, red reflex is an “illumination” of the anterior chamber achieved by bouncing light off of the retina back towards the front of the eye. This is achieved by using dual lights, strategically positions and directed. This creates a much brighter, clearer view of the cataract and the capsule. This technology has existed for years, but older technologies had a smaller “zone” where reflex was achieved. This meant that if the patient or microscope moved slightly, the surgeon would lose his enhanced view. Red Reflex has come a long way in the last 10 years. The Alcon LuxOR LX3 claims a 6x greater Red Reflex zone than other microscopes. The Zeiss Lumera family offers what they call “Stereo Coaxial Illumination” which they claim to be excellent reflex even on very mature cataracts. Leica’s M822 offers a similar coaxial “OttoFlex” reflex system, which offers a larger than normal reflex zone than previous Leica models. If none of the other benefits make a difference to you, we believe that greater reflex zones make a substantial difference in the cataract experience for the surgeon, and it’s worth a try!

2) Light Sources & Objective Lenses

Each brand of microscope will have slightly different setups of light source and objective lens placement. The LuxOR LX3 Illumin-i technology, for example, places the objective lens above the light source, claiming that this creates clearer illumination as the light does not pass through the objective lens like other models. The Leica M822 uses a dual illumination system that combines LED & Halogen light sources. Why does this matter? Every part of the microscope makes a difference in what the surgeon sees and experiences during the surgery. To the trained eye, these all make noticeable differences.

3) Integrated Technology 

Most new microscope models have integrated technology options on board that may be useful and helpful to the surgeon. Some of the models we’ve mentioned above have different options for integration. For example, some have the ability to link to enhanced visual overlay systems that give the surgeon technical overlay layouts in his ocular view. Most come with an option for video attachments, savable surgeon user settings, wireless Bluetooth foot pedals, auto-locking arms, and more.

You may be looking at the list of benefits and feel that most are non-essential for a skilled surgeon. Depending on the surgeon, that may be true. But the main thing to take into consideration is that the comfort level of the surgeon is paramount during the surgery. If the surgeon doesn’t have to struggle to keep the eye in focus or in red reflux, that will make the surgeon’s job easier. If their ocular view is clearer, crisper, and brighter without turning the light up to 10, the surgeon should be more comfortable during the operation. These factors can even benefit the most skilled surgeon, bringing more comfort and ease to the operation. Interested in a side-by-side comparison? Take a look at this article published by the Journal of Clinical Case Reports, comparing the newer Leica & Zeiss models side by side.

We feel all the benefits listed above should at least be looked at and considered. And here’s the best part…if you are interested in upgrading your cataract technology in the near future, Surgical Direct is able to help you upgrade without spending your Capital.

Surgical Direct Inc provides the latest cataract technology to your facility for $0 of capital investment. We provide tailored equipment and supply lists for the surgeon’s specific needs, including the desire to try new technology as it comes out. With Surgical Direct, you get a safer, more efficient cataract experience in your facility. Don’t believe us? Read through our testimonials to see what our customers are saying about our services.

Interested in learning more about what we offer? Visit our Mobile Cataract Services page to find out more about what we do. Have a more pressing question or need? Call us directly at 1-800-346-0544.

Upgrading Cataract Technology Improves Safety & Efficiency

From a physician’s point of view, the safety of their patients during cataract surgery is of utmost importance. No surgeon wants to put their patient at risk during an operation. No surgeon wants anything less than the best outcomes in their patient’s vision. What if I told you that using old equipment puts your patients at a higher percentage of risk than when using new cataract technology? The truth is that you may be the most skilled cataract surgeon in the US and still have a percentage of risk based solely on the equipment you are using. Not only are their safety benefits when upgrading cataract technology, but there can also be time saved per case (efficiency benefits), potentially making your surgery day more profitable. In this article, we want to explore a few areas of the cataract procedure, phacoemulsification, and new technology that have been largely improved upon over the last 10 years.

So, what are some safety and efficiency benefits that come from upgrading cataract technology?

1) Phacoemulsification Efficiency

Newer Phaco platforms such as the Centurion Vision System and the B&L Stellaris have greatly improved ultrasonic cutting platforms that bring greater cutting efficiency at lower output levels. This allows for a reduction in Cumulative Dispersed Energy (CDE), cutting through dense cataracts with lower power thresholds. Lower CDE means better next day outcomes for the patient. Better cutting efficiency also means that there is a higher percentage of your cases that will take less time to emulsify the cataract. This has the potential to reduce the case time per patient, which in effect can allow for the potential for more cases in a surgery day. Read this interesting article about Torsional amplitude from the Centurion. Also, This article published by IMedPub Journal offers great insight on metrics and efficiency comparisons between the Alcon Infiniti & Centurion. We feel it’s worth a read and can offer deeper technical insight into the benefits of upgrading cataract technology. Also feel free to review an earlier post of ours “Why Upgrade from Alcon Infiniti to Alcon Centurion” for our in-house benefits list of upgrading to the Centurion. 

2) Enhanced Chamber Stability

Almost every new phaco machine on the market boasts about their enhanced fluidic systems onboard. Centurion’s “Active Fluidics” is the industries only non-gravity based fluidic system that holds intra-ocular chamber pressure by active pressure plates. This system allows for an incredibly “quiet” chamber, reducing chamber bounce and unexpected pressure surge. In short, this technology reduces the risk of a post-occlusion surge dramatically, making every case safer for the patient and smoother for the surgeon. The B&L Stellaris and WhiteStar Signature Pro alike boast about enhancements in their fluidic programs. Both of these machines still operate by gravity-based fluidics, but both tote noticeable improvements in chamber stability due to machine’s software updates.

Newer phaco systems, across the board, give you safer, more controlled environments in which to operate in. Safer for the patient + more stability for the surgeon = a boost of confidence operatively and quicker/smoother surgeries.

3) Red Reflux & Newer Optics

Another area of benefit from upgrading cataract technology is in optics. Ophthalmic Microscope technology over the last 10 years has greatly improved! Newer microscopes like the Alcon LuxOR LX3 offer a 6x greater area of red reflux than other microscopes on the market. It also has a different objective lens position (above the light source) creating un-hindered illumination. Both of these technologies together provide an incredibly clear view and a depth of focus to the surgeon. Zeiss is known for their incredible optics, and the OPMI Lumera models offer amazing optical views to the surgeon. No matter what you choose, a newer microscope with newer technology on board will provide a better optical view of the surgery than an older microscope. Sharper focus and clearer views of the eye will assist the surgeon in completing the case safer and more efficiently.

These three areas only scratch the surface of new technology in refractive surgery. You may be thinking by now that throughout this article we’ve just been stating the obvious. I kind of agree. It seems fairly obvious that newer technology will assist the surgeon in performing surgery more efficiently. But the truth is that there are many surgeons who become so comfortable with the platform they are using (and have been using for years), that they are hesitant to try new technology, even if it would help them improve their outcomes and provide more safety for their patients. On the other side of the coin, there are surgeons who want the newest technology as it comes out. At Surgical Direct, we understand both dynamics and provide options for everyone.

Surgical Direct Inc provides the latest cataract technology to your facility for $0 of capital investment.

We provide tailored equipment and supply lists for the surgeon’s specific needs, including the desire to try new technology as it comes out. With Surgical Direct, you get a safer, more efficient cataract experience in your facility. Don’t believe us? Read through our testimonials to see what our customers are saying about our services.

Interested in learning more about what we offer? Visit our Mobile Cataract Services page to find out more about what we do. Have a more pressing question or need? Call us directly at 1-800-346-0544.

Save Capital Dollars on Cataracts

Surgical Direct can help your bottom line.

Over the last few years, Medicare reimbursements for Cataract Surgery have been on the slow but steady incline (between 1-5% depending on the type of facility). This is great news if you are facilitating or interested in facilitating cataracts in your OR, and should be an incentive to pursue cataracts. But this doesn’t help you save capital dollars on cataracts.

Even though the reimbursements have risen, the cost of surgery is increasing and investing in new technology can put a big dent in your capital funds. However, not investing can stifle the inflow of patients that surgeons want to bring to your facility because they don’t want to be stuck using old technology. Surgical facility administrators are then forced to make a decision…(a) invest a large amount of capital or (b) run the risk of losing the business. This all depends on the annual case volume of cataracts in your facility. However, it’s fairly safe to say that if your facility is a surgery center or hospital, investing in new Cataract Technology may not actually help your bottom line.

So the question poses itself here.

If you are not an Eye Center, can you stay current with technology and equipment while keeping cataracts profitable in your facility?

Yes, you can!

Save Capital Dollars on Cataracts with Surgical Direct’s Mobile Cataract Services.

Surgical Direct provides a unique cataract equipment outsourcing model that eliminates the need for capital expenditure on cataract equipment, making your cataract cases profitable from day1. Our pricing model is priced by the case and is only a percentage of your Medicare reimbursement. Not to mention, NO long-term contracts. What does this mean? This means you get the latest technology for cataracts (and a happy surgeon), without spending a dime of capital, and your facility makes money every case.

To get an idea of a real-life example of savings that we can deliver, you should read this article “There’s that Cataract Van Again” from September’s issue of Outpatient Surgery Magazine, written directly about our services by one of our long-time customers.

In the article, you will see a cost breakdown of this particular surgery center’s annual savings in a Buy vs Outsource comparison.

Our goal is to be a source of information and a resource to you. We know that outsourcing equipment does not make sense for everyone. That’s why we have put together a quick checklist for you to see if outsourcing can save capital dollars on cataracts in your facility. If you answer yes to any of the 5 below, we believe you are a candidate.

  1. You are a facility that is looking to upgrade your existing cataract equipment.
  2. You are a hospital or surgery center that facilitates cataract cases and/or you have multiple surgeons requiring different technology and case supplies.
  3. You are currently not facilitating cataracts in your facility but have the desire to start and lack the capital to get it going.
  4.  You simply don’t have the time and manpower to keep up with the intense inventory management required for eyes.
  5. You have the capital, but you are not sure you want to invest in eyes because you are unsure of the Doctors long-term commitment to the platform that is being requested.

All of the scenarios above are scenarios we’ve seen first hand in facilities that were at a crossroads about purchasing new equipment, simply because they could not justify the capital expenditure. That is the beauty of outsourcing. You get the latest technology in your facility, spending $0 capital. But the real beauty of our service model doesn’t stop there. Our services include a whole slew of other benefits like inventory management of all cataract case supplies, lens consignment management, hands-on technicians in your OR on every surgery day, and more.

Interested in learning more about what we offer? Visit our Mobile Cataract Services page to find out more about what we do. Or call us directly at 314-997-4455.

The Cataract Caddie – 4 Traits of the SDI Cataract Technician

At Surgical Direct, we offer Mobile Cataract Services to Hospitals, ASCs, and Ophthalmologists all over the country. A Cataract Technician is provided on every surgery day with Surgical Direct. From experience, we know that eye surgery can often be viewed as “another world” to the surgical staff. Often times, the surgical staff at any particular OR may have 1 to 2 people who are familiar with Cataract Surgery. Some facilities that we step into have NO one experienced with eyes. Needless to say, this can cause the staff to be under stress on eye day. Cataract Surgery is a very repetitive procedure with high success rates, but this does not mean that it’s a simple procedure. It’s a highly-detailed, microsurgical procedure with numerous steps requiring precision and incredible detail. Each instrument is unique and has a specific purpose. One small circumstance can change the surgery dramatically, creating the need for backup instruments, a different lens implant, or specialty items that the surgeon hasn’t used in months.

Unless your facility is an “Eye Center”, the likelihood of your staff being familiar with all the possible scenarios that could come about on surgery day is slim. The unknown or lack of knowledge can create a sense of anxiety on eye day, not only for the staff in the room but for the surgeon as well.

Meet your Surgical Direct Cataract Technician – The “Cataract Caddie”

A vital part of our Mobile Cataract Service model is our Technician. It might seem silly to take a cherished past-time (golf) and a surgical procedure and try to cross-reference similarities. One is a sport, a past-time, a way to relax and get your mind off of life on a beautiful par 5. The other is a surgical procedure that can greatly determine the future eyesight of a human being…not to be taken lightly in the slightest. 

However, when discussing what it is we actually do as a company, the picture of our Surgical Technicians being like a caddie in your OR on eye day is a simple and accurate way to paint the picture. In fact, one of our very own technicians (Dustin Anthony – Regional Operations & Phaco Technician), of his own inspiration, wrote about his position at Surgical Direct Inc and references the “caddie” concept and his pride in his role. Read his post on LinkedIn, we think you’ll enjoy it.

The definition of a golf caddie (according to Wikipedia) “is the person who carries a player’s bag and clubs, and gives insightful advice and moral support. A good caddie is aware of the challenges and obstacles of the golf course being played, along with the best strategy in playing it.”

1) We carry the “bag and clubs”

The SDI technician brings the equipment needed for the surgeon to “play his best”. He brings the latest technology to the OR on surgery day. And just as a caddie cares for the clubs, making sure that they are clean, and ready when needed, a tech ensures all the equipment is ready to go for each surgery.

2) We provide insight & moral support

In order to become an SDI technician, you must go through an initial 90-day intensive training, complete with a final exam. Each technician is trained thoroughly in Phacodynamics, OR protocols, Aseptic training, principals of light, anatomy of the eye, and our intensive equipment training program. And that’s just the first 90 days! An average SDI technician provides support for roughly 80-100 cases per month. And the majority of our technicians have held their positions for years. Each cataract technician has the technical know-how to provide insight to the staff and surgeon on the equipment, supplies, instruments, and lenses. But just because we may know a lot of about the surgery, doesn’t mean that we are above taking the trash out, running to the clean core to help find an instrument the surgeon is asking for, or helping turnover the room in between cases. Support is our service.

3) We are aware of the challenges and obstacles of the course.

The in-depth training and sheer volume of surgeries our technicians have been through creates an awareness of surgical steps and the possible outcomes should an issue arise. The majority of the time, our technicians are prepared and ready for possible issues. A seasoned technician can be alerted to issues simply by hearing a change in the machine’s pressure reading tone, or knowing when a surgeon is performing a certain step slower than expected. If the surgeon expects that a case might be complicated, he alerts the tech of possible items that he might need during that case. Our techs take it a step further, and know that “if he opens this, then he might need that….and I’ll want backups in the room just in case so I don’t have to run out of the room to get them”. Preparedness and awareness of the “obstacles” help the surgery day run as smooth as possible. Happier staff. Comfortable surgeon. Better outcomes! Better day!

4) Relationship builds trust

“Behind every successful golfer is a caddie with a steady presence”. Read this fascinating article The 36 Greatest Caddies of All Time, and I think you’ll agree that relationship plays a vital part in trust and success of a golfer and his caddie. We believe this to be true with our cataract technicians as well. That’s why we do our best to schedule our technicians strategically every month so that our accounts are seeing familiar faces. Our technicians become part of your surgical staff on eye day. Over the years, many have become “work family” in our accounts. It’s our goal to provide that “steady presence” so that every surgeon and staff we work with can achieve success.

There are several mobile cataract services out there. But we firmly believe that our cataract technicians at Surgical Direct are what makes our service stand out.

Could your OR use a Cataract Caddie? Want to know more about Surgical Direct and what our services can bring to your OR? Check out our recent post about 5 Headaches Eliminated with Mobile Cataract Services to see how Surgical Direct can help alleviate your cataract surgery stress. 

5 Headaches Eliminated with Mobile Cataract Services

As with every surgical procedure, Cataract Surgery comes with a fair share of preparation, work, and readiness in order to have a smooth day with good outcomes. Whether you use Mobile Cataract Services or not, preparation is essential for a smooth “eye day”. Pre-operatively, there are supplies to be ordered and pulled, lenses to be picked, equipment to be checked, and the room made ready. Intra-operatively, equipment has to be calibrated properly for every case, machine settings adjusted for difficult cases, room turnover has to be timely, and back up supplies/lenses ready and available on standby in case they are needed. Post-operatively, the equipment has to be cleaned according to manufactures standards, supplies have to be re-ordered for the next surgery day, and not to mention all of the paperwork!

All the preparation and energy mentioned above are standard for cataract surgical cases. But what happens when you have a difficult case, an equipment failure, or an instrument come back broken after a case? Your work (and time) has likely just doubled! These are what we call “headaches”. We call them headaches because we have found that many surgical facilities that are not an “Ophthalmic-only Surgery Center” struggle with keeping up with all the details that encompass Eye Day.

So, how can Mobile Cataract Services help eliminate these headaches?

Let’s look at 6 “headaches” that have the potential to be eliminated using Surgical Direct’s Mobile Cataract Services.

1) Never-ending Inventory

Routine Supplies: Cataract Surgery is generally a very successful and routine surgical procedure. A skilled surgeon can perform 10-20+ surgeries a day depending on his/her level of skill. High volume surgeons require large amounts of inventory to get through their surgery day due to the number of cases they perform. It’s also vital to have back-ups of everything in case contaminations occur. Standard case supplies such as blades, drapes, cannulas, BSS, viscoelastic, lenses, and instruments are needed every case and can total up to 30+ items per case. Each surgeon has their preference for supplies, brands, and specialty instruments. If you have more than one surgeon operating in your facility, the inventory list can become rather large, and each can be drastically different in spec from the other.

Specialty Supplies: In Cataract Surgery, there are rarely-used specialty items that a surgeon may call for from time to time in certain situations. A number of these items are so rarely used that it is possible if not likely that they will expire on the shelf before they are used. However, if you do not have these items on-hand when they are needed, it can be detrimental to that patient’s vision. Keeping the items on hand can be frustrating and expensive, and often results in a loss.

Lens Consignments: There is a lot of time and energy that must go into managing a lens consignment. In most cases, a surgeon will require 2 or 3 different lenses on hand for each patient, requiring the management of up to 3 consignments. And if you have multiple surgeons operating at your facility, that number could increase based on their preferences. On top of that, specialty lenses like Toric and Multifocal models are becoming popular, but a surgeon’s volume in that particular lens model may not be enough for you to receive a full consignment. This means that each specialty lens must be ordered separately and arrive in time for surgery.

Surgical Direct’s Mobile Services has the potential to eliminate all the inventory headaches. We bring tailored surgeon-specific supply lists, specialty items, and backup supplies into your facility on surgery day, including lenses. This inventory will never touch your shelves and are climate controlled in our clean storage facility. You will not have to deal with ordering supplies, replenishing lens consignments, or stocking your shelves with eye supplies again.

2) Limited Storage Space

As mentioned above, Cataract supplies (especially with high-volume surgeons) can equate to a lot of inventory. This can also equate to a lot of space used up on your shelves. We can attest first hand that not all surgical facilities have adequate amounts of storage space for all the inventory that is needed. Including inventory, the surgical equipment must be stored when not in use. After being in hundreds of surgical facilities, we know that finding a few square feet to store a microscope can be a challenge. Also, take into account that an Ophthalmologist may only operate in your facility 1-2 times per month. This means that all of his inventory and equipment uses up valuable space in your facility for 28 days a month. It just sits there!

In our Mobile Cataract Service model, Surgical Direct brings all equipment and supplies into your facility on the day of surgery. This eliminates the storage space “headache” from the equation, freeing up loads of shelf and floor space in your storage rooms.

3) Equipment Failure & Repairs

Now this one is a major headache. It’s a surgical staff’s worst nightmare to have equipment failure. Every other detail in the day could be running as smoothly as possible, and then everything comes to a standstill when the Phaco Machine alerts an error message. Or the Phaco Handpiece will not pass its pre-surgery test. Or there is a problem with the Microscope and the surgeon cannot bring it into focus. What do you do? How do you fix it? Malfunctions like this can easily cause cancellations and frustration for staff, surgeon, and patients alike.

When you use Surgical Direct, you gain a qualified, well-trained technician on surgery day. Our technicians bring the equipment to your facility and ensure that all the equipment is working efficiently throughout the day. If an equipment failure should occur, our technicians are trained to diagnose the problem and provide solutions to fix it. If the problem is deeper and cannot be addressed on site, it’s our policy to always have a backup machine on-hand in case of such situations so that the day can keep moving forward as planned.

4) Staffing and Training Holes

Adequately staffing the room on eye day is an important key to having a smooth and timely cataract day. Circulators and scrub technicians already have their hands full of requirements and tasks throughout the case. In our experience, it is very effective to have another person in the room each case, that can help with the machine, supply-runs, turnover, and opening extra supplies. The headache lies in that many facilities do not have staffing for an “extra hand” in the room, especially on a busy day in the OR. Having someone well-trained in the technique of opening sterile supplies is very helpful. An added benefit would be to have someone who is well-versed in the equipment and how it works, able to make machine adjustments for the surgeon on request, and troubleshoot problems.

This is where we come in. As mentioned, Surgical Direct’s Mobile Cataract Services provides a technician that can provide all of the above. Our technicians are trained in Aseptic technique annually, trained how to open sterile supplies, adjust equipment settings, and provide outstanding support. On top of that, they are friendly, alert, and ready to help wherever needed. Our technicians truly are the difference in our service model vs other services and will bring a whole new level of comfort and ease into the OR.

5) Surgery Day Anxiety

Anxiety has a way of affecting our performance. When under stress, we react to situations in ways we normally would not react. The 4 previous headaches discussed in this article are common areas that we have encountered frustration amongst Hospital and ASC administrators and staff members. It’s the culmination of all of these put together that bring “Surgery Day Anxiety”. We believe that our Mobile Cataract Services can bring your surgery day anxiety down to 0, for your staff and for the surgeon. Time and time again, we are told by our customers that Eye Day is no longer a source of anxiety, but is enjoyable, smooth, and a good day.

Surgical Direct exists to serve you!

Are you considering a Mobile Cataract Service for your hospital or ASC? Are you a surgeon who knows of a similar situation in a facility as described in this article? Please reach out to us in the comments below and tell us about your “Surgery Day Anxiety”.

Perhaps we can help be the solution.