Ophthalmology Business

MAR 2014

Ophthalmology Business is focused on business topics relevant to the entrepreneurial ophthalmologist. It offers editorial, opinion, and practical tips for physicians running an ophthalmic practice. It is a companion publication of EyeWorld.

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12 Ophthalmology Business • March 2014 by Keith A. Walter, MD Patient conversion to laser cataract surgery Y ou board a commer- cial airplane trusting that your pilot will do a good job and deliver you safely to your destination. As you buckle yourself in for the long haul, the pilot announces that the GPS system is out of commission and that the autopilot controls are broken. The pilot then declares that he is an excellent pilot and only requires a compass and a runway to safely fly the airplane. Do you stay on the plane? Just like boarding a plane without truly knowing the skillset of the pilot, a cataract patient enters the ophthalmologist's office without an understanding of how good that surgeon is. Likewise, as the GPS and autopilot system provide a level of security to the airline passenger, laser cataract surgery helps assuage a patient's fear over the element of human error and provides a virtual safety net. Converting patients from tradi- tional to laser cataract surgery has been an easy transition for me. I discovered quickly that my patients want this technology; they find comfort and reassurance in knowing that their surgeon is using the best technology. The laser safety net Utilization of the laser has the p otential to make a great surgeon better by simplifying the procedure and reducing surgical time while producing consistent, good out- comes. Patients also enjoy having their astigmatism corrected during the procedure, producing a better outcome than can be achieved with manual surgery. Learning to use the laser was quite easy for me. I have extensive experience performing LASIK surgery and am accustomed to the suction ring going around the eye, as well as the process for acquiring centration around the cornea. However, I have witnessed surgeons who have never performed LASIK pick up the process in one training session without any difficulty. This short learning curve speaks to the ease and efficiency a quality laser interface is capable of providing. Our femtosecond laser for cataract surgery performs four mod- erately difficult steps with ease and perfection. The initial step is the incision of the eye; a surgeon must go by "feel" when performing this manually. The laser eliminates the variability associated with using a blade and going in either too soon or too far. The surgeon avoids com- plications such as iris prolapse, often associated with making the incision too short, or having a difficult view by making the incision too long. Second, a quality laser performs a perfectly round capsulotomy, exactly sized and centered, in just 1.5 seconds. Manually, the capsulo- tomy takes 30 seconds to one minute. When performing this step by hand, particularly when you are learning, the capsulotomy can often 02-19_OB March 2104_Layout 1 2/19/14 11:07 AM Page 12

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