Posts

3 New IOL Related Technologies On The Horizon

The IOL implant market has experienced rapid development and ground-breaking advances in technology in the last 20 years. Toric and Multifocal implants continue to rise in popularity and manufacturers continue to improve their respective models’ accuracy in refractive outcomes.

At Surgical Direct, part of our Mobile Cataract Services is to provide easy access to wide varieties of IOL models to our clients, eliminating their need to carry additional consignments or special ordering lenses. A partnership with Surgical Direct allows access for surgeons and hospitals to the latest technologies that otherwise may not be an option due to capital budget.

Today, we thought it would be interesting to highlight 3 IOL technologies that are on the horizon in this market. These technologies are still in development, beta, or clinical trials, and not available to use in the US market (disclaimer).

3 New IOL Related Technologies on the Horizon.

 

1) Postop Refractive Adjustment

PostOp Refractive Adjustment is a post-op laser treatment where the surgeon is able to alter the diopter size of an already implanted IOL using a femtosecond laser and an optical focusing system. The laser doesn’t change the thickness or shape of the IOL, however, it changes the hydrophilicity of the lens. So far it’s been tested on Acrylic lenses from all the major manufacturers and has had great accuracy in achieving the desired change in diopter. If this system is approved for public use in the future, it would dramatically change the game, eliminating the needs for explanting IOLs with miscalculated diopters. As the patient ages, there is potential for an annual adjustment of the IOL’s diopter for the best possible vision from that IOL. Something to think about!

2) Small-aperture IOL

AcuFocus has now created a monofocal intraocular lens (IC-8) that uses the “pinhole effect” principle to alleviate distortion and expand depth-of-field in an IOL implant. The basic principle is similar to the KAMRA corneal inlay…which only allows central, focused light to reach the retina, removing the blur caused by peripheral defocused light. The results (in theory) would mean the highest quality of vision over the broadest continuous range of any premium IOL currently available. This essentially means that this technology could compete directly with the multifocal market, providing a high-quality dynamic range of focus in a monodical lens.  The lens has received FDA approval for clinical trials, so it will be interesting to see the results of those trials and whether this lens is brought to market.

3) The Omega Gemini Capsule

The Omega Gemini Capsule is essentially an artificial capsule that is implanted into the eye in order to create a stable environment to house other ophthalmic technologies such as IOL implanted, medication delivery, and augmented reality technology.  The Gemini Capsule props the capsule open, is 3 dimensional and creates artificial “walls” within the capsules, enforcing the stability of the implantable space. Omega’s future hope is that Gemini will provide the ability to house implantable technology (in addition to IOLs) for the future, things like augmented reality devices. This is very future-forward in thinking. This product too will be interesting to see if it reaches approval.

Surgical Direct is your partner in ophthalmic technology, and our goal is to make it as easy as possible for our surgeons and OR staff to gain access to today’s latest technology.

For more information about what we do provide, click below to learn about our Mobile Cataract Services.

 

Call Toll Free | 800-346-0544

Sign up for a FREE Demo Day

More about our Mobile Cataract Services

The Ins and Outs of IOL Lens Management

In Cataract Surgery, there are many integral parts of the procedure that need a high-attention to detail for that patient to have optimal results. But one of the most important aspects of cataract surgery and its success rate is the IOL Lens Implant.  The surgeon has taken much time and focus on making sure that calculations for the lens implant are dead-accurate. Having the right lenses, specialty lens picks, plus backups for everything just in case is very important, not only for a smooth day but for the patient! Let’s walk through some of the ins and outs of IOL lens management and how we take care of the WHOLE IOL process at Surgical Direct. 

IOL Lens Management is a BIG JOB. 

1) Before Surgery Day

As we already mentioned, the IOL implant is one of the most crucial aspects of cataract surgery. It’s extremely important to be over-prepared in this department, ready for any unforeseen issues that may arise during the case.

Every cataract case should have measurements for 3 possible lens implants, 1) A primary lens, 2) A Sulcus (3-piece) implant, and 3) an Anterior Chamber lens. It’s important to have all 3 of those lens picks available for that specific case. Each of those lenses is requested for specific case scenarios. If the capsule is unstable, the surgeon may request his Sulcus Implant. If a deeper issue arises, the surgeon may request an AC lens. Generally, the primary lens will be implanted in the 85-90th percentile of cases (some situations could be less or more). But for that 10-15% of cases that need a backup lens opened, generally it’s not an optimal scenario for the surgeon, and not having the right lens can make a stressful situation even more stressful.

We say all of that to say, preparedness is crucial!

Let’s say that your surgeon brings 10 cases per surgery day. That’s an immediate 30 lenses that need to be accounted for on that day (from 3 different consignments). That doesn’t include making sure you have backup lenses in case of contaminations. That also doesn’t include the scenario that your surgeon may be requesting premium lenses (like Torics or Multi-focals), or different brands/models throughout the day.

Let’s give you a quick example of scale. In the Toric market alone, now very popular for astigmatism correction, Alcon has 9 levels of correction power. That means that there are 9 different models of Toric that your surgeon may ask for. Each model has a 6-30 Diopter range in half diopter intervals. The leading manufacturers in IOL implants (like Alcon and J&JVision) come out with new models and technology every year. And now, there are Toric-Multifocals that also have different models with different correction powers. With all the different options available today, the days of just having 2-3 consignments to meet all the surgeon’s IOL needs are coming to an end, if not already over.

It’s important to keep pace with this because surgeons will likely request the new technology when it’s available and giving them the opportunity to do so can improve patient satisfaction and offer a higher level of care.

So back to prep, before the day even begins, all of the requested lenses need to be ordered, organized, checked for expiration/contamination, and ensure there are adequate backups for any unforeseen issues. Ask anyone who manages lens consignments….it’s a lot of work. But it doesn’t stop there…

2) During Surgery Day

During surgery, the lenses need to be ordered carefully to be sure that there is NO confusion on which lens is right for that patient. It takes the whole room being focused and aware that the lens that is opened is THE right lens that the Doctor has asked for. Double-checking (even triple-checking) is highly recommended. Every lens will come with its specific manufactured lens implantation device (generally an injector and a cartridge) that needs to be ready in order to properly inject the lens. When you get into having 2-3 different styles of lenses, there needs to be a lot of attention to detail on which lens is being opened and which corresponding injector system needs to be ready. Each lens will come with implant stickers that need to be charted and reported for that patient, not only for medical records but for manufacture implantation reporting and consignment re-ordering purposes.

All of that preparation and work is for a normal, routine case. What if there is a problem with the implant? What if a lens is contaminated? What if a lens is implanted, then explanted due to unforeseen problems? There is extra paperwork that needs to be processed for that specific lens and case.

3) After Surgery Day

An equal amount of effort used in prep and during surgery also needs to be put towards your lens consignment post surgery. Every lens opened and implanted needs to be documented and accounted for. Every lens will have a card that needs to be filled out and sent back to the manufacturer for reporting purposes. Then, you’ll need to process a report for your lens consignments to be refilled. Special reporting needs to happen for lens returns. And all of this has to be done in a timely fashion so that the consignments are fully restocked before the next surgery day (at which the process starts all over again). Shipping costs on lenses and time allotted for restocking your consignments must be considered as well.

Here’s the good news you’ve been waiting for.

Are you ready for it?

Surgical Direct provides a mobile cataract service that not only provides your facility with the latest cataract technology without spending a dollar of capital funds, but we also manage the entire lens process for you!

In addition to supplying state-of-the-art cataract equipment, disposable supplies, and an ‘on-the-ball’ technician, we manage over 50 in-house lens consignments from 3 different lens manufactures, including back-up and specialty lenses like Torics & Multi-Focals. 

Our in-house full-time lens & inventory manager has been managing our lens processes for over 7 years. He spends a considerable amount of time every week on followup with doctors’ offices, coordinating needed lenses for every surgery day, and ensuring we provide the right lens for every patient. If a lens exists and the surgeon asks for it, we can provide it. We take care of all lens requests from the surgeon’s office, lens ordering, special ordering, consignment replenishments, shipping, receiving, and re-stocking.

How much time does your lens management take away from your week?

Call us today and let us take this off your plate! You can try our services first hand for FREE. Sign up for our Free Demo Day and experience Surgical Direct first hand at no charge. (see demo day page for full details).

For an in-depth full listing of what we offer at Surgical Direct, Click Here. 

Call Us

Sign up for a FREE demo Day

What All does SDI Offer?

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.

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.