Posts

How much are cataracts really costing you?

When purchasing cataract equipment (phaco machines and ophthalmic microscopes), not only do you have to take into consideration the initial cost but also the long-term expense it will take to keep your equipment maintained and surgery-ready. On top of that, cataract costs can go even deeper into your profit margins when managing your own inventory (case supplies, lenses, and special instruments like tonic markers and CTR inserters). Did you know that partnering with Surgical Direct can dramatically lower how much cataracts cost your facility?  What is the real cost of owning cataract equipment? Let us break it down for you…

What’s the real cost of owning cataract equipment and managing your own supplies?

1) Initial Capital

Easily the highest expense of owning cataract equipment is purchasing it. Purchasing cataract equipment (phaco machines, handpieces, and microscopes) can easily cost your facility over 6 figures in capital expenditure to be ready to facilitate cataract surgery (and if you are considering having 2 rooms operational for cataracts, double that figure). That’s no small dent. But the real challenge in the ophthalmic specialty is keeping up with how quickly new technology is released. Software upgrades typically are released annually which cost you to upgrade. On average, manufacturers release new phaco platforms every 7-10 years, meaning that you may need to re-invest in new technology on that timeframe. Ophthalmology is one of the most rapidly advanced specialties in the medical field.

2) Repairs and Preventative Maintenance

If you purchase cataract equipment for your facility, you must take into consideration the cost of maintaining your equipment. Phaco machine service contracts with manufacturers can cost an average of 5-7k per year (in a multiple year contract). And that’s just 1 phaco machine PM plan. Now let’s talk about repairs. Here’s a list of the most common phaco issues concerning repairs:

  • Phaco Foot Switch (3-5k)
  • Phaco handpiece failures (2-4k)
  • IV pole malfunctions (2-4k)
  • Fluidics hardware malfunctions (3k+)

These are average prices and the most common issues you’ll see from our experience. While still on the topic of phaco repairs, we also have to mention the loss of business and costs that correlate if your surgery day is halted or canceled by equipment failure. Not only will your facility lose revenue due to canceling surgery, but it’s a major hassle to reschedule patients, coordinate special service calls, and so on. 

3) Case Supply Waste, Lens Management, & Shipping Costs

If you manage your own case supply inventory at your facility, you’ll know that there is almost always some percentage of loss you’ll experience (from expirations to contaminations to damages). With cataract supplies, you may also know that there are specialty items necessary to have on hand just in case the surgeon might need them. Items like Capsular Tension Rings, Malyugin Rings, Iris Hooks, and Vitrectors (just to name a few) are items that need to be available if the surgeon asks for them. Some of these items are so rarely used, that they often expire on your shelf before they are used, which is a loss in your inventory. And of course, because of the nature of these supplies, they tend to be the most expensive of the cataract case supplies that you’ll order.

Managing your own lens consignments can cost you a significant amount of time and money between processing orders and reorders, shipping charges, special orders, restocking, etc. We also cannot forget to mention all the shipping costs that you will pay for all inventory items including lenses, regular supplies, overnight charges for last minute orders, and instrument repairs. Shipping costs on supplies and lenses can be significant over time.

4) Time & Space

Think for a moment of all the time that’s invested in preparing for cataract day. Ordering inventory, stocking supplies, pulling case supplies for surgery, managing multiple vendor PO’s, custom ordering specialty lenses, reordering and restocking used lenses; the list goes on…and that’s just for a normal day when nothing goes wrong! What about when a machine goes down? Patients have to be rescheduled and surgery needs to be re-coordinated with the surgeon. If transportation is involved for patients, that needs to be re-arranged. Service calls with the manufacturer need to be coordinated, arranged, invoiced, and paid. All of this is time that you (or someone on your staff) is taking out of their week to manage. When it comes to space, many surgical locations are limited in storage space. Cataract equipment and case supplies can eat up 200-400 sq ft of your precious storage space.

Surgical Direct provides a mobile cataract service that saves you time, money, space, and stress.

It really is simple. Surgical Direct will provide the latest cataract equipment to your facility when you need it (just for surgery day – even for 2 rooms days) so you don’t have to spend your capital on cataract equipment. Our equipment is manufacture maintained and routinely serviced with the same service contracts you would have if it were in your facility. We always provide a backup machine in case of equipment failure (because it does happen), and when it does, we pay for the repairs. We provide adequate handpiece volume for your surgery day caseload so surgeries can move along at a normal pace (even with today’s sterilization standards). We provide all the inventory you’ll need for surgery…including case supplies (drapes, blades, cannulas, viscoelastics, etc), instruments, lenses, and those rarely used backup supplies (excluding pre and post-op meds). And all of this comes at a per-case price that is only a percentage of your facility’s cataract reimbursement. OH, and did we mention no long-term contracts?

2019 is the year that you can upgrade your equipment without spending a dollar in capital and save money and time on inventory management.

Check out our post about 5 Headaches Eliminated with Mobile Cataract Services to see how Surgical Direct can help alleviate your cataract surgery woes.

Call us anytime with your questions! Or 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).

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.