Improving preoperative work-flow streamlines custom ablation practice

Optimized patient flow and consistently successful results with custom ablation can be attained by paying attention to details and by training staff to be efficient with wavefront-related procedures, according to David R. Hardten, MD.

Dr. Hardten said rather than trying to determine at the outset which patients are most suitable for customized ablation, he performs wavefront analysis on all patients and uses the results to decide which ones are most suitable for the procedure.

He said that with customized ablation, mean postoperative uncorrected visual acuity has improved significantly from conventional LASIK results. In his practice, 92% of patients achieve 20/20 or better uncorrected visual acuity and 99% achieve 20/25 or better UCVA.

Dr. Hardten said having an efficient and knowledgeable staff is also important for a streamlined work-flow. Staff should be trained to perform wavefront analysis, topography, pupillometry, pachymetry and patient history.

Nomograms should be adjusted when necessary, Dr. Hardten said. He suggested creating a spreadsheet containing patient age, manifest refraction spherical equivalent, sphere and astigmatism. Controlling the humidity in the office also benefits the procedures, he said.

Dr. Hardten will discuss patient flow in a custom refractive surgery practice at Hawaii 2005, The Royal Hawaiian Eye Meeting.