6 Things to Consider Before Buying or Upgrading Phaco Machines & Microscopes

Purchasing medical equipment is a big decision with a large amount of weight for admin staff. Cost, Long-Term reliability and ROI and just a few obvious details that should be considered. But we believe there are more corners in the room that need to be scanned before making your final decision.

If you are in the market for a phaco machine for your hospital or ASC, there are:

6 things we think you should consider before buying or upgrading phaco machines and microscopes.

 

1) Do you have the capital?

One of the biggest factors in purchasing equipment is price and whether that purchase will bring a healthy ROI to your facility. The main questions when it comes to cataract surgery is (a) will you have enough volume to make the capital investment worth it, and (b) is there another specialty field that could benefit more from your capital dollars and provide a higher ROI for you facility? Surgical Direct provides the solution that allows you to maximize your capital funds to where it will make the most sense, and still acquire the use of today’s latest phaco technology in your OR right away. Along with obtaining the equipment you need, we provide more than enough phaco trays for today’s stringent sterilization regulations.

2) Repair & Maintenance Costs.

Not only do you need to delegate funds for purchasing the equipment (and all accessories and supplies that come with your phaco), but it’s equally important to allocate funds for ongoing maintenance & repair costs. Manufacture preventative maintenance is absolutely essential to keep your equipment running safely and correctly for surgery. But this is an added expense that can cost you tens of thousands over the life of ownership and that doesn’t even touch the scenario where you need an additional repair or part. At Surgical Direct, all of our machines are enrolled in the same PM schedule with the manufacturer that your machine would be, providing the same level of upkeep and care to your facility without the ongoing (and unexpected) bills.

3) Disposable Supply, Lenses & Inventory Upkeep.

Of course, every phaco machine comes with specific accessories and supplies that only work with that specific machine. Are you and your staff in a position to manage these aspects efficiently? Surgical Direct’s Mobile Cataract Service provides everything needed. Handpieces, tips, sleeves, tubing packs & bss are machine-specific and must be on hand for surgery. We take care of all the details like all disposable case supplies specific to each surgeon’s preference, including standard & premium lenses for each case.

4) Brand & Surgeon Loyalty.

Since purchasing is a big ROI decision, you want to be sure of a 2 things before pulling the trigger with confidence. 1) Is this machine (and it’s brand) a good fit for the surgeon (or all of the surgeons that might be using it) longterm? Short term thinking does not produce good ROI results. Are you certain the surgeon will be happy with this machine longterm? 2) Are you certain the surgeon will be operating in your facility longterm? There is no obvious answer to these questions because there is no guarantee of the future. Surgical Direct gives you the flexibility to use a machine as long as you like with not buy-in or tie-down. Switching brands or upgrading to the latest model is EASY!

5) Staff Training & Troubleshooting.

New equipment means new things to learn. Does your team have the capacity to learn all the ins-and-outs of the new technology? Knowing what to look for, troubleshooting inconsistencies and errors, and acting quickly can be the difference between a smooth day and day full of cancellations. Surgical Direct provides highly-trained and helpful technicians each surgery day in your OR that uses our service. Our techs are specifically trained on the equipment to know how to circumnavigate issues to keep the equipment working all day. Plus, if the issue is too technical, we bring backup machines!

6) Cataract Technology Advances Quickly.

No matter how certain about all of the other 5 topics we discussed, there is still the fact that Ophthalmic Surgical Technology is one of the fastest evolving/changing specialties in the medical field. New tech is introduced almost annually and can be difficult to stay on top, not only financially, but practically.

We bring all of this up to let you know that if you are considering purchasing a phaco machine, you have options! Exploring a Cataract Outsourcing partnership with Surgical Direct could be the solution that saves your facility tens of thousands in capital, provides the latest technology, award-winning support, and consistent reliable ROI that you can track.

Our solution is mobile, turn-key, and simple. We would love to speak with you about how together we can make a smoother, more efficient cataract program.

Call Toll Free | 800-346-0544

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Alcon Centurion VS B&L Stellaris Elite

Today, we wanted to do a quick comparison on 2 of the highest-rated phaco machines in today’s market, Alcon Centurion Vs B&L Stellaris Elite.

Phacoemulsification platforms are highly advanced pieces of medical equipment. Ultrasonic phacoemulsification was first introduced in the 60s, but it wasn’t until the 80s that it didn’t catch on as the primary method of cataract removal, and even then, there were still many skeptics. Since the ’90s, phaco has taken a drastic upturn and has become the primary method of cataract removal, resulting in a 98% success rate on all cataract surgery operations. That’s pretty astonishing and heavily due to how sophisticated phaco technology has developed.

So let’s look at 2 big players in today’s market and look at their selling points.

What are the main differences between Centurion and Stellaris Elite?

 

The Alcon Centurion Vision System

1) Onboard Ultrasonic Technology

Centurion carries over the powerful OZIL Phaco Technology from its predecessor (Alcon Infiniti), along with some significant upgrades. Centurion gives the option to use traditional/ longitudinal ultrasonic patterns or OZIL’s patented Torsional ultrasound, or a combination of both at the same time. This is no different from the Infiniti, however, Centurion introduced the INTREPID Balanced Tip to the market (which is only available with Centurion). The Balanced Tip offers more effective cutting at the tip, which less movement at the incision. This has proven to be highly efficient in emulsifying dense cataracts with less power output.

2) Fluidic Technology

Arguably one of the best features on Centurion is its fluidic technology. Centurion uses Active fluidics, which means that gravity drip is not at play on this system. Instead, the bag of BSS is hosting between two sensored plates. Highly-sensitive pressure reading sensors, constantly read intraocular pressure throughout the procedure, sending signal to the plates to adjust the inflow of fluid. This allows the surgeon to set a desired IOP for the case, and Centurion will keep that IOP inside automatically. This creates a “stable” or “quite” chamber for the surgeon, greatly reducing the chance of post-occlusion surge, etc. The fluidic pump is a Peristaltic pump, which builds vacuum pressure incrementally, but due to this system’s software, we’ve never heard a surgeon complain about the available vacuum levels this machine can produce.

3) User Interface

Centurion’s user interface is intuitive, sophisticated, and highly programmable. The user touch screen is extremely accurate and the interface is user-friendly, giving accurate detailed reports at all times. Centurion also offers solid (and familiar) interface elements to the surgeon. The Centurion’s foot pedal is wireless, solid (made of metal no plastic), and easy to navigate during surgery. The Centurion OZIL handpiece feels just like the old Infiniti OZIL handpiece, so it feels familiar to those who have used Alcon platforms. Plus it has Luer locks on the IA ports, reducing those annoying “the tubing line fell off the handpiece” scenarios.

 


The Bausch & Lomb Stellaris Elite Vision System

1) Onboard Ultrasonic Technology

Stellaris Elite is the newest released phaco platform. The Stellaris platform has existed for quite a few years. Think of the Elite as the latest version of Stellaris. Stellaris Elite introduces Attune Energy technology to the phaco market with a six-crystal handpiece that delivers optimized 28.5 kHz frequency for consistent power delivery and increased stroke length. 

2) Fluidic Technology

Stellaris Elite hosts a Venturi pump, which is a chamber based vacuum system. This means that a vacuum chamber is pressurized and used to access high levels of vacuum on demand. Venturi is nothing new to Stellaris (all previous versions have Venturi pumps as well), but the difference with this system is its Advanced Vacuum Module StableChamber Fluidics System. StableChamber minimizes surge and allows for high-vacuum surgery through an incision as small as a 1.8mm.

3) User Interface

Like Centurion, Stellaris Elite hosts an intuitive, highly-customizable, and easy-to-navigate user interface that allows for effortless customization of case settings and defaults. Elite also provides the surgeon with familiar handpiece interfaces (if they’ve used B&L systems before) and the foot pedal is also wireless. Another notable feature about the foot pedal is that it’s dual-linear and programmable so the surgeon can have full control of aspiration and ultrasound separately.

4) Posterior & Anterior Segment Options

In many respects, both Centurion and Stellaris Elite and similar. The biggest marked difference between the 2 is that Stellaris Elite is a multi-procedural system. In addition to providing a highly advanced and stable environment for cataract surgery, Stellaris Elite is also one of the leading platforms in Posterior Segment. Vitesse Hypersonic Vitrectomy System onboard the Elite is the most sophisticated and programmable vitrectomy system to date. This makes the Stellaris a viable option for both Cataract and Retina surgeons, providing both a cutting-edge and safe operating system.

 


The Surgeon’s Preference Wins!

Surgeons tend to have loyalty to certain systems or brands based on familiarity. But we’ve often found that many surgeons are very interested in switching platforms when new technology is introduced to the market. However, many are stuck using old phaco platform due to a deficiency in capital.

Surgeons should be able to pick and choose what platform is best for their surgical process. They should be able to try new technology as it comes out. This has the potential to increase the level of care they offer their patients.

Surgical Direct Inc offers the ability for any surgeon to access today’s latest phaco, microscope, IOL, and other ophthalmic technology at no upfront cost. Our Mobile Cataract Service model is designed to allow surgeons to use the technology they want and opening the door for options without burdening the facility with large capital expenses.

Want to try Centurion, Stellaris Elite, or another phaco system in your facility? Give us a call today and inquire about a Free SDI Demo Day.

Call Toll Free | 800-346-0544

Sign up for a FREE Demo Day

More about our Mobile Cataract Services

The Growing Need for Cataract Instruments

The Situation with Sterilization.

Surgical procedures, in general, require a lot of instrumentation to be sterilized in preparation for surgery. Like all specialties in surgery, Ophthalmology requires very specific instrumentation. When we are talking about ‘cataract instruments’, we are talking about the ophthalmic instruments (cataract tray), the phaco handpiece, and IOL insertion devices.

One notable difference that makes cataract instruments different is their size and fragility. But this is just one “small” part (no pun intended) of the cataract instrument situation that needs to be thought about to make the surgery day a success. What about volume? How many sets do you need to make the day a success? The truth is (with changes to sterilization standards in the last 15 years), it seems that the required amount of instrumentation for a typical eye day is growing and growing. Let’s dissect the reasons why this is such a big issue, and how Surgical Direct can help in this area.

So, why do you need so many Cataract Instruments? 

 

1) Case Volume & Speed

In 2015, Review of Ophthalmology published an article that says that the national average of cataract case volume per surgeon in the United States is about 400 cataract cases per year. Some obviously would land higher than that, some lower of course. But if we take that average, it equals approx 7 cases per week.

Let’s just say your surgeon brings an average of 7 cases to your facility on a surgery day, with an average case time of 20min. That’s an average of 3 cases per hour. If your surgeon falls into the “quick” category, this number can go up. Keep in mind that it’s best practice to have a backup set sterile and ready in case an instrument is dropped or contaminated. So that gives us a total of 4 sets of cataract instruments needed per hour of surgery. And saying that actually feels modest.

2) Modern Sterilization Times

Next, we have to factor in how long it takes to sterilize cataract instruments. Using the most up-to-date sterilization standards, a facility needs 45min-1hr of process time for instruments to be sterilized (which has increased substantially in the last 15 years with stricter state and medical governing body regulations). What used to take 15min, now will take 1hr, which means that the first set of cataract instruments used that day will not be ready to be used again until 1.5hr after the first case starts. It’s also interesting to note that average case times per surgeon are getting faster due to the latest technology, which is increasing the surgeon’s efficiency and helping them get through cases faster. This makes for an interesting dilemma.

3) Standard & Specialty Instruments 

Every surgeon has their preferred instruments. Cataract surgery does not have too many varying methods. For the most part, every surgeon will perform the surgery using the same primary steps. However, this does not mean that every surgeon will use the same instruments. Many surgeons will use different instrumentation than another surgeon to perform the same surgical step. This means that if you have more than one surgeon operating in your facility, your instrumentation will need to increase. Of course, some surgeons will have added steps based on their surgical preference, also increasing needed instrumentation.

Then there is the issue of backup or specialty instruments that are only needed in special situations. It’s important to have multiples of these in order to cover all possible scenarios and not be stuck waiting for sterilization to move forward with the day.

4) The Impending Baby-Boomers 

Another layer to think about in this area is that we are on the cusp of the baby-boomer generation becoming within the average age of cataract development. Why does this matter? The numbers listed above in point #1 are numbers taken in 2015. Each year, the average cataract surgeon will take on more cases just to handle the demand, and it’s only going to increase as the baby boomers develop cataracts and need surgery. This means that the need for more instrumentation will only be inevitable in the coming years.

To sum up, it’s a very complex situation that requires a lot of instruments and attention to detail to pull off a smooth cataract day. By now you are probably trying to factor how much it’s going to cost in purchasing instruments and phaco handpieces to keep up with the demand. Maybe you are already here in your facility. Before you invest, consider Surgical Direct’s Mobile Cataract Services.

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. We are able to help with instrumentation demands (both in cataract instruments, and phaco handpieces). 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.

Want to experience our services first hand for FREE? Request a Surgical Direct FREE DEMO DAY.

Why Cataract Outsourcing makes sense.

Let’s say your hospital or ASC has come to a point where you have realized that acquiring new cataract equipment is inevitable. Your current equipment is old and outdated, repairs and maintenance costs are becoming more frequent, and your surgeon is starting to request the latest technology on the market.  You will likely be met with 2 options to meet your future needs…purchase or look for a cataract outsourcing service.

1) Purchase new equipment. With this option, not only will you need the upfront funds to purchase the equipment, but you will also likely have to invest in ongoing maintenance packages, software upgrades, and future repair costs. All of these costs cause the profitability of your cataract cases to be quite low for years due to your upfront investment. You will also need to factor in storage space, training for your staff, etc.

2) Outsource with SDI. Our cataract outsourcing model enables you to start doing cataracts (or upgrade your old equipment) with NO upfront costs. There is no need to purchase costly equipment, or pay for preventative maintenance plans, or use up valuable storage space in your facility. Our pricing is factored on a per/case basis so your cases are profitable to your facility from day 1. 

In addition, SDI provides IOL consignments, ancillary inventory supplies from all the major ophthalmic manufacturers, and a dedicated Surgical Coordinator on the day of surgery. Our coordinators are manufacturer trained to operate the equipment in assistance to your staff and surgeon.

For more information about our services, visit our services page.

Alcon Launches LuxOR™ Surgical Ophthalmic Microscope

LuxOR_image_product-missouri

The LuxOR expands Alcon’s ophthalmic surgical portfolio to provide a comprehensive solution for ophthalmic procedures.

One of the key functions of a microscope is to provide the surgeon excellent visualization. Visualization is greatly facilitated by red reflex, which is achieved when coaxial light is reflected off the retina.

Alcon’s LuxOR Surgical Ophthalmic Microscope has a unique illumination technology that provides excellent visualization during all stages of cataract surgery. It features patented illumin-i technology which maintains a consistent and stable red reflex regardless of pupil size, centration, lens tilt or patient eye movement. The red reflex zone of the LuxORMicroscope is 6x larger than a traditional microscope, shown in the diagram below1.

redzonecomparisonWith proprietary positioning of the light source below the objective lens, the LuxORprovides exceptional detail recognition and contrast as well as greater depth of focus: approximately 60mm longer focal length, regardless of the working distance, compared to a traditional microscope1 as shown below.

lenspositioncomparison2

Centurion Phaco Released by Alcon

Centurion-phacoAlcon has released the CENTURION® Vision System — a new phacoemulsification (phaco) technology platform designed to provide surgeons improved capabilities in cataract removal.

The CENTURION® automatically and continuously adapts to changing conditions within the eye, provides greater anterior chamber stability during each step of the procedure, and places an “optimized energy technology” at the surgeon’s fingertips through enhanced fluidic management and surgical precision.

Technology Overview & Unique Features

The CENTURION® Vision System sets a new standard of performance in cataract surgery by combining multiple intelligent phaco technologies, and other key features, including:

  • Active Fluidics™ Technology, an automated system that optimizes anterior chamber stability by allowing surgeons to proactively set and maintain target intraocular pressure (IOP) within the eye during the cataract removal procedure.1 This provides enhanced IOP control during the procedure in comparison to gravity fluidics and fixed pressure irrigation; reduces surges due to occlusion breaks; increases IOP efficiency at lower, more natural settings; and eliminates the need to manually adjust fluid pressure.
  • Balanced Energy™ Technology enhances phacoemulsification efficiency through proven OZil® Intelligent Phaco and the INTREPID® Balanced Tip probe. This increases efficiency and control, while reducing energy levels, and accommodating surgeon settings for aspiration and vacuum by keeping the fragmented lens material at the shearing plane for emulsification. 2,3
  • Applied Integration™, an innovative design that enables the new system to be seamlessly integrated with multiple cataract surgical technologies, like Alcon’s LuxOR™ Surgical Microscopes with Q-VUE™ 3-D assistant and the LenSx® Laser to create a comprehensive cataract surgery suite designed to minimize variability at every step of the procedure.
  • The CENTURION® Vision System also offers an improved ergonomic design, wireless footswitch and intuitive touch-screen display.

Here’s a video recently posted on YouTube showing the benefits of Centurion: