OASC | TECHNOLOGY

Should You Consider a Cataract Suite?

Several companies are bundling devices, IOLs and disposables with measurable benefits for ASCs.

By Erin Murphy, Contributing Editor

Treatment of a cataract.

Cataract surgery presents ASCs with a variety of purchasing decisions ranging from capital purchases to IOLs and disposables. When an ASC requires a new technology to provide the highest level of care to its patients, administrators must weigh the potential purchase’s capabilities and compatibility with existing technologies, as well as surgeon preferences and financial considerations to decide whether or not the purchase is a good fit for their center.

Today, administrators and surgeons have the option of purchasing a suite of cataract surgery products produced by one manufacturer. Is a cataract suite the right choice for your ASC?

What’s in It for the ASC?

Manufacturers of cataract suites promote three primary advantages for their customers: lower costs, efficiency and convenience.

Lower costs. Whenever an administrator is considering multiple purchases from a single manufacturer, it’s wise to ask about cost incentives. Companies that design and sell cataract suites do so with those incentives in mind.

“When we talk to people about purchasing more than one piece of equipment, along with IOLs and consumables such as phaco packs, we’re really talking about a long-term agreement that has to make sense to them in terms of both product performance and economic value,” says Becky Kirkwood, Bausch + Lomb’s U.S. marketing director for the Victus femtosecond laser. “We work with the customer, evaluating case volumes and procedural costs, to ensure that they earn cost advantages by purchasing a suite of products.”

Efficiency. When ASCs buy from a single manufacturer, they have a single purchasing contract and point of contact, which allows administrators to spend less time ordering lenses and disposables. Whether they need to optimize or upgrade their devices or have a piece of equipment serviced, they have a single point of contact at the company.

“Our clients typically have one go-to person, an account manager who functions as a concierge for anything from product questions to tech issues. That manager oversees several people who handle specific support functions,” explains Robert Raney, America’s phaco product manager at Abbott Medical Optics.

As Ms. Kirkwood points out, “Every client and purchase is different, but whenever an ASC is talking about purchasing more than one piece of capital equipment, there should be some efficiencies and economies in terms of service contracts and technical support.”

Compatibility. High-tech devices are designed to be compatible with your network, image management system and electronic health records. Although the devices in any cataract suites are compatible with those from other manufacturers, some have added harmony within the brand.

“Cataract surgeons have never really had the option of assembling their diagnostic tools, pre-operative planning, operating suite instrumentation, IOL choices, and a complete customizable procedure pack of disposable products, all from one company that designs each element to work together,” explains Matt Bachmann, director of marketing for cataract equipment at Alcon. “Now surgeons can source all of their critical needs from one company, from surgical planning in the clinic through every step of the surgical procedure.”

Mr. Raney adds, “Everything is designed to work together — IOLs, an implantation system designed and labeled for those IOLs, the right phaco incision size, phaco optimization for laser cataract surgery.”

Joseph Boorady, senior vice president of sales and service at Carl Zeiss Meditec, says ASCs experience the benefits in outcomes and efficiencies. “A suite of equipment with pieces optimally matched provides enhanced value for physicians because it offers true compatibility and interconnectivity that, in turn, help deliver greater efficiency and improved surgical precision.”

The coherent design of cataract suites has workflow advantages as well, according to Mr. Boorady. “In today’s environment of increasing reimbursement pressure, surgical practices are driven to seek more efficient workflow while still maintaining the highest quality patient outcomes,” he says. “We meet this need by integrating the most innovative technologies into a cohesive workflow that matches how physicians like to work.”

Abbott Medical Optics (AMO)

“AMO’s product portfolio offers an array of options that allow surgeons to choose products based on their individual techniques and preferences. We focus on delivering a range of unique best-in-class products. Whether it’s IOLs, phaco devices, lasers or viscoelastics, each of our products has some attributes that only we offer,” Mr. Raney says. “For example, we have a disposable insertion device that’s preloaded with an IOL. Rather than loading the IOL, the technician simply fills the cartridge with viscoelastic to advance the lens. It’s faster and requires no reusable instruments.”

The Whitestar Signature System is a modular ophthalmic microsurgical system.

AMO’s full Micro-Implantation Cataract Suite covers the full range of products needed to perform surgery. Its Whitestar Signature phacoemulsification system makes both peristaltic and venturi pumps available to surgeons during a procedure. Elliptical movement of the phaco tip permits gentler fluidics and ease of removal for both soft and hard cataracts.

Also included in AMO’s suite is the Unfolder Platinum 1 implantation system series for the company’s Tecnis 1-Piece IOL. Finally, the Healon OVD series facilitates a number of procedures including cataract surgery, while a range of micro-implantation tools and accessories such as knives, tips and sleeves round out the cataract suite.

Alcon

The most recent innovations from Alcon Surgical are the Verion Image Guided System, the Centurion Vision System and the LuxOR LX3 Microscope. These three elements combined with the LenSx laser comprise the instrumentation portion of the Cataract Refractive Suite.

Alcon’s Centurion Vision System.

The Verion Image Guided System measures keratometry, pupillometry and other parameters for cataract surgery, while capturing high-resolution reference images of the eye. The system’s digital marker feature helps surgeons optimize incision placement and IOL alignment.

“The Verion Image Guided System is unique because it delivers image driven guidance to the surgeon throughout the cataract procedure that the surgeon customizes for each patient,” says Mr. Bachmann.

Alcon’s LenSx Laser, the first femtosecond laser approved for cataract surgery, is upgraded regularly with the goals of improved speed and outcomes for cataract procedures. Alcon emphasized the large visual field and reduced need for focus adjustment with the LuxOR LX3 with Q-Vue Ophthalmic Microscope. Finally, the company’s Centurion Vision phacoemulsification system monitors and adjusts to conditions in the eye during surgery to ensure that the intraocular pressure is stable.

Although Alcon doesn’t group them into its Cataract Refractive Suite, the company also offers cataract surgeons its line of AcrySof IQ IOLS and DisCoVisc viscoelastics. According to Mr. Bachmann, “The suite of instrumentation combined with the AcrySof line of IOLs, and the high level of surgeon support provided by Alcon, is the unique offering in cataract surgery today.”

Bausch + Lomb

Bausch + Lomb doesn’t market a cataract suite per se, but the company does offer a comprehensive range of capital equipment, IOLs and disposables. Some equipment is designed to serve multiple specialties in the ASC.

The Victus femtosecond laser platform is used in both cataract and LASIK procedures.

“Our Victus femtosecond laser can be used for both cataract procedures and to create the LASIK flap for refractive surgery,” explains Ms. Kirkwood. “In ASCs that have both cataract and refractive surgery, that versatility makes sense. The facility amortizes costs and service fees on one platform instead of shouldering two.”

The range of Bausch + Lomb cataract products includes several devices and a range of supplies. The Victus femtosecond laser platform is flexible for ASCs, explains Ms. Kirkwood.

“The Victus platform’s bed now swivels 70 degrees, allowing surgeons to put a laser in the OR and swivel the bed far enough to perform a phaco procedure in the same room.”

Another cataract device is the Stellaris Vision Enhancement System, whose fluidics and incisions enable surgeons to perform surgery for lenses below 2 mm at insertion.

“In femtosecond procedures, it helps to have the ability to use a vacuum-based system, and our Stellaris platform has that precision,” Ms. Kirkwood says.

Bausch + Lomb’s Crystalens, SofPort, Akreos and enVista IOLs serve a variety of functions, including reducing aberrations, enabling microincision surgery and eliminating glistenings from patients’ vision. Finally, the Amvisc, Amsvic Plus and OcuCoat Viscoelastics give surgeons a range of choices for individual cataract cases.

Carl Zeiss Meditec

“The Zeiss Cataract Suite seamlessly integrates the gold standard IOLMaster biometer and OPMI Lumera 700 microscope with the Callisto Eye computer-assisted surgery system for biometry, visualization and toric IOL implantation,” Mr. Boorady says. “In this surgical platform for cataracts, the components are designed to work together for the benefit of the surgeon and the patient.”

Carl Zeiss Meditec’s Callisto Eye is an OR management system.

The Zeiss Cataract Suite includes these three devices. The IOLMaster 500 helps surgeons select the right IOL for each patient with a system designed to be reliable, straightforward and easy to use. The Callisto Eye is an OR management system that enables surgeons to visualize incisions and IOL placement by superimposing them through the eyepiece of the OPMI Lumera 700 microscope. That microscope, the third element of this cataract suite, is designed for clear optics and ease of use with an “exhaustive range of customization options.”

Mr. Boorady adds, “Patented SCI stereo coaxial illumination in the OPMI Lumera line provides a brilliant red reflex without compromising the ability to resolve details.”

A Suite or a Mix?

Many ophthalmic ASCs already own devices from a variety of manufacturers, because purchases are made over time, and the need to replace or upgrade occurs at different time points for different machines. IOL choices depend on many factors, including surgeon preference and patient needs. And when there’s a significant advance in any product, an ASC might purchase it regardless of manufacturer. However, there are advantages to consolidating your purchases with a cataract suite, especially for those ASCs looking to purchase more than one device. ■