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Cataract surgeon presents ‘wish list’ to industry
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MILAN — What are the top wishes of cataract surgeons and the things industry partners should do for their benefit and the benefit of their patients?
At the OSN Italy meeting, Kevin Miller, MD, presented a rich and varied list, ranging from cloud-based synchronized services to transfer information and machine settings across operating rooms, to power-adjustable IOLs, which are, in his opinion, “the future of cataract surgery.” Also included were extended-range single-piece IOLs and specially designed U-shaped instruments to separate femtosecond laser-cut nucleus fragments because “current slit-like chop patterns do not allow us to get our instruments in between pie-shaped nuclear fragments.”
One simple trick to increase patient comfort would be to provide a near-body temperature balanced salt solution for infusion at the end of a procedure, when the viscoelastic is being aspirated.
“By this time, the intracameral anesthesia is gone, and the sudden 10° drop in eye temperature causes the eye to ache in much the same way as quickly drinking a cold drink causes a ‘brain freeze,’” Miller said.
Phaco machines, he suggested, should have a last quadrant or last fragment setting to alert surgeons to the importance of fluidics during last quadrant or last fragment removal.
“Also, change ‘pre-phaco’ setting to ‘working space’ to emphasize the importance of clearing a working space in the OVD to prevent phaco burn,” he said.
One change of direction he strongly advocated is to stop hyping premium IOLs in direct-to-consumer advertising.
“Not every patient is a candidate for a premium IOL, and premium IOL implantation is no guarantee of spectacle-free results. Industry sets up for expectations we cannot always meet,” Miller said.
He also noted that colleagues sometimes hype premium IOLs even more than the manufacturers do.
His No. 1 wish is for a round-edge single-piece acrylic IOL with a large optic designed specifically for the sulcus space.
“I am thinking of a 7- or 7.5-mm round-edge optic and round-edge haptics suitable for passive placement in the ciliary sulcus in eyes with capsular bag compromise or for scleral suture fixation in eyes with absent capsular support,” Miller said. – by Michela Cimberle
Reference:
Miller KM. Ten things industry partners should do for the benefit of cataract surgeons and their patients. Presented at: OSN Italy meeting; May 18-19, 2018; Milan.
Disclosure: Miller reports he is a consultant for Bausch + Lomb and Johnson & Johnson Vision.