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Premium surgery should aim for perfection
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ROME — The shrinking U.S. dollar is leading to a division between old-fashioned cataract surgery for those who cannot afford newer technology and premium cataract surgery, which is of increasing interest to U.S. surgeons, a clinician said here.
John A. Hovanesian, MD, OSN Cornea/External Disease Board Member, asked if everyone is ready for premium cataract surgery at the annual joint meeting of Ocular Surgery News and the Italian Society of Ophthalmology. Doing premium surgery means doing perfect surgery, he said.
"For a start, we need a near perfect ocular surface and accurate biometry using the best technology and calculation formulas," he said.
Multifocal and accommodating lenses need a potential vision of at least 20/25, and scanning methods such as optical coherence tomography help determine if the macula is healthy through an opaque lens. The endothelium should be carefully checked using endothelial microscopy or at least a slit lamp examination to rule out endothelial disease. Surgical trauma must be reduced by using up-to-date phacoemulsification machines. Femto-phaco looks promising and should further develop in the next few years, Dr. Hovanesian said.
"We must use kinder, gentler, preservative-free medications that allow greater potency and less frequent dosing. Finally, we must ask our patients questions to learn what makes them unique, because the same surgery and same lens does not work for everyone," he said.
- Disclosure: Dr. Hovanesian has no relevant financial disclosures.