2019 Cataract Surgery Trends

Happy Holidays from all of us at Surgical Direct!

It’s that time of year where we all begin to think about the year ahead and all that it holds. We’d like to take the opportunity to give you a shortlist of advancements and trends that we feel will be become more prevalent in 2019 in cataract surgery. Our job isn’t to sell products, but to be a resource of information and knowledge. We don’t have any agenda. This is just our opinion of what you’ll see more of in 2019 in cataract surgery.  Let’s jump right in!

Here’s our 2019 Cataract Surgery Trends short-list.

1) Premium IOLs

 

a) MultiFocal & Toric IOLS

Premium lenses are becoming more and more popular with surgeons and patients. We feel that there will be an increase in volume that these IOLs are implanted in 2019. Not only are these lenses being improved upon in quality and accuracy, but new science and technology is being added to them seemingly every year. And with the latest addition to the premium IOL industry with Toric/Multifocal (2in1) lenses, patient satisfaction and scoring higher and vision outcomes better as these developments are made. So, we feel in 2019 you’ll see more premium lenses added to your surgery days.

b) Adjustable IOLS

There is a new technology on the market as of early 2018 called the “adjustable IOL”. This is a lens that is implanted with a diopter size (similar to a normal IOL). The difference is that 2 weeks post-op, the surgeon can adjust the diopter of the IOL to attain 20/20 vision, non-surgically! The IOL uses a proprietary photo reactive silicone material. If the patient is not 20/20 at the post-op vision test, the IOL power can be changed by a 1-2 minute exposure of a low-intensity beam of ultraviolet light (delivered by a specialized machine) to change the shape of the lens according to the patient’s prescription. FDA studies show that twice the number of patients are able to ditch glasses and have 20/20 vision after cataract surgery using this technology. Read more about the lens here.

The lens hasn’t caught on yet in large volumes, primarily due to lack of exposure. Any new technology naturally takes time to gain momentum. But our opinion is that we may see and hear more about this lens in 2019. In fact, many believe that it’s only a matter of time before the Adjustable IOL becomes one of the most disruptive and innovative technologies to hit cataract and refractive surgery in recent years.

2) Disposable Instruments

 

In many ways, the name of the game in cataract surgery is efficiency. Of course, patients and their health always come first! But it’s always been a drive in the refractive and cataract surgery market to make things more efficient. With more and more regulations being enforced on sterilization standards over the last years, there has been a big push and increase in disposable instruments. Many of the major players (such as Alcon and B+L) have already started with disposable IA handles, phaco sleeves, tubing, cannulas, etc. But we feel this trend is going to go deeper in this direction in 2019, possibly even into secondary instruments such as forceps and hooks regularly used per case. Companies like MST and BVI are already mass-marketing these disposable instruments. Will reusable instruments go away in 2019? Not at all likely. But we feel we will begin to see more incorporation of disposable instrumentation.

3) Phaco & Microscope Developments

Up until now, there has not been much marketed about upcoming or new developments in the Phaco and Microscope markets. There is always speculation, but nothing has been announced. Alcon’s Centurion is still dominating the phaco market, and we suspect that turnover to this machine will continue in 2019. Abbott (what used to be AMO – creator of the WhiteStar Phaco system) was acquired last year by Johnson & Johnson. With new financial backing, maybe there will be an announcement of development there? Per usual, during the annual AAO conference is typically when announcements will be made on new technology that is being developed or released. We’ll be sure the publish another article after the AAO on what is in the pipeline in this area.

And of course, every year now we get further and further into the era of baby boomers coming into cataract surgery range. This means that in the next years, we are going to see a huge influx of cataract needs in the US. We believe it’s so important to have a trusted partner in cataract surgery. That is our goal at Surgical Direct.

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.

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.