SPOTLIGHT ON TECHNOLOGY & TECHNIQUE

Software upgrade improves cataract surgery outcomes

LenSx’s latest software upgrade assists surgeons with patient outcomes.

By Zack Tertel, Senior Associate Editor

Although Lawrence Woodard, MD, of Omni Eye Services in Atlanta, has been pleased with his LenSx Laser system (Alcon) for laser refractive cataract surgery, he says the company’s recent 2.23 software upgrade is a significant advancement. The device’s new features are more than just bells and whistles: they help to improve patient outcomes, he says.

LenSx Laser System’s 2.23 software upgrade includes automation capabilities and fragmentated grid patterns.

“I’ve essentially had 98% free-floating capsulorhexis, and more than 95% of my corneal incisions open without the use of a blade,” he says. “Prior to the upgrade, those [percentages] just weren’t that high.”

FRAGMENTATION PATTERNS

With the software upgrade, surgeons can use a fragmentation pattern to separate the nucleus into a customizable grid. “To me, the ability to fragment with the grid pattern was just a monumental improvement,” Dr. Woodard says.

The fragmented grid pattern allows surgeons to divide the nucleus into many small sections. Therefore, Dr. Woodard says, he can treat a wider diameter of the nucleus and aspirate it through the phaco tip as opposed to using ultrasound energy to break up the nucleus before aspirating it. Also, limiting the ultrasound energy used during surgery prevents ultrasound shock waves from dispersing throughout the patients’ anterior segment. Dr. Woodard says over 60% of his patients had a cumulative dissipated energy (CDE) ratio of 0, a significant improvement over prior procedures.

AUTOMATION

LenSx Laser’s 2.23 upgrade has the ability to pre-position the capsularhexis and lens treatment based on custom pre-set parameters, such as centering based on the limbus, preoperative pupil or visual axis.

Dr. Woodard says he previously struggled with this portion of the cataract surgery procedure, particularly asymmetric dilated pupils.

“Trying to visually determine where the center of the eye is and where the visual axis is can be very challenging,” he says. “Having that pre-position function with the laser eliminates the guesswork.”

Dr. Woodard says this improved his accuracy with centering patients’ IOLs, especially with multifocal IOLs. “The center 2 mm of the multifocal IOL is essentially a monofocal optic that needs to be centered on the visual axis,” Dr. Woodard says. “The IOL tends to want to be centered based on the capsulorhexis, so the more successful you are at centering that capsulorhexis, the more successful you will be at keeping that IOL centered.”

VERION

With toric IOL patients, Dr. Woodard says he used to take the time to continuously walk to the preoperative area and mark patients himself.

“I didn’t want to trust anyone else with that because the marking is so crucial for getting everything just like you want it.”

Now, LenSx’s software upgrade allows surgeons to use Alcon’s Verion Image Guided system, which uses a customizable surgical plan to register the patient’s eye based on a previous image. Dr. Woodard says he can rely on Verion and no longer needs to mark patients.

In addition to the time savings, Dr. Woodard says he’s seen a marginal improvement in toric IOL post-op results by removing guesswork from the equation.

“We’ve all reached that point where we would mark a patient at 0 degrees and 180 degrees, then you realize those two marks aren’t exactly 180 degrees apart and you have to estimate the exact median,” he says. “Eliminating that inaccuracy has been very comforting to me.”

CONCLUSION

After LenSx’s 2.23 software upgrade, Dr. Woodard says he’s getting the most out of the device, which adds to his practice’s reputation for having access to premium technology. It also boosts his relationships with referral sources.

“They have confidence to know that their patients will have access to all of our technology to deliver the best possible results,” he says. “That continues to help drive our referral sources to send patients to us.” OM