Bausch + Lomb’s SeeNa delivers improved efficiency and workflow for cataract surgeons.

Ask ophthalmic surgeons Mark Lobanoff, MD, and Caroline Watson, MD, what their pain points are when it comes to preparing for cataract surgery. Like many of their peers, they are quick to answer: efficiency and workflow.

“One of the most critical resources in a clinic these days is time. More and more ophthalmologists are entering retirement age, and the rate of producing new ophthalmologists is not keeping up with the rate of retirement,” says Dr. Lobanoff, director of cataract surgery at OVO LASIK + Lens in St. Louis Park, Minn. “And yet the population of patients who have cataracts and pathology is growing as our population ages, so every ophthalmologist is now faced with seeing more patients and doing more with less time.”

To help address these challenges, Bausch + Lomb introduced SeeNa, a combination biometer and topographer that captures nine measurements for evaluating patient vision and calculating IOL power in one acquisition. Along with keratometry, anterior chamber depth, central corneal thickness and corneal topography, SeeNa takes corneal white-to-white measurements and performs corneal wavefront analysis and photopic and mesopic pupillometry.

AN 'ALL-IN-ONE' SOLUTION

“Because SeeNa is truly an all-in-one device, surgeons and staff don’t have to move patients to different rooms and multiple machines to get the measurements needed for IOL calculations and surgical planning,” says Anthony Wallace, vice president and general manager, North America, Bausch + Lomb. “This conserves space and time, streamlining workflow and contributing to a better patient experience.”

Dr. Watson, a cataract, refractive, and cornea surgeon at Alabama Vision Center in Huntsville, Ala., agrees. “[SeeNa] is a compact powerhouse. However, what sets it apart is that it seamlessly combines the functionality of two technologies,” she says.

GREATER ACCURACY

Among SeeNa’s other features and benefits, Dr. Watson and Dr. Lobanoff are particularly impressed with SeeNa’s accuracy. They highlight its excellence in measuring astigmatism for toric IOLs. Many surgeons, Dr. Lobanoff notes, only use a biometer to assess for astigmatism without also taking the time to examine the corneal topography. The problem with that approach, he says, is that not all patients have symmetrical astigmatism; some have asymmetric astigmatism, with a large, broad inferior lobe and a comparatively tiny superior lobe.

“If you put a toric lens that corrects 1.5 D of corneal astigmatism in an eye that has asymmetric astigmatism, you’re correcting the bottom correctly, but over-correcting the top, or you’re correcting the top correctly and under-correcting the bottom,” Dr. Lobanoff says. “SeeNa keeps you out of that trouble and allows you to see what the astigmatism pattern looks like. These are important things as you’re considering the lens for the patient.”

Both surgeons also appreciate the SeeNa’s ability to analyze higher-order aberrations such as coma, which can adversely impact the outcomes of premium lenses. “That’s a huge advantage to this machine,” says Dr. Watson, who specializes in refractive, MIGS, and cornea and ocular surface reconstruction. “I leverage a diverse range of lens technologies, always mindful of the impact on the cornea when making surgical decisions for our patients,” she adds.

Approximately 80% of her patients involve surgical procedures, and the remaining 20% encompass various procedural interventions. “Consequently, all patients undergo a comprehensive array of measurements to ensure precision and tailored care.” 

Dr. Lobanoff, who also specializes in cataract/refractive surgery, estimates that 90% of his cataract patients request premium IOLs. "My patients are expecting as close to perfection as you can get. That means we really need to nail the diagnostics, we need the good, reliable data, and we need to do a very careful job of calculating and planning the lenses,” he says.

COST EFFECTIVE FOR LARGE AND SMALL PRACTICES

Another advantage to SeeNa is its cost, which Dr. Lobanoff says amounts to “tens of thousands of dollars” less than similar devices that don’t measure as many visual characteristics as the SeeNa. This makes it cost-effective for small practices that don’t have the capital to invest in multiple devices, as well as for larger practices that desire to equip multiple locations.

“There’s not only the cost of the machine itself, but there are maintenance costs for every machine,” he says. “Two machines mean two maintenance contracts, and SeeNa is able to cut that down.

A USER-FRIENDLY TECHNOLOGY

Both surgeons also tout the SeeNa’s ease of use. While some diagnostic equipment requires significant time for technician training and/or can have difficulty obtaining consistently high-quality images, technicians are up and running with the SeeNa within just a few hours, says
Dr. Watson.

“It captures quickly. It captures effectively. It’s one and done,” adds Dr. Lobanoff.

CONNECTIVITY FOR EFFICIENCY

Finally, SeeNa is fully integrated with Bausch + Lomb’s Eyetelligence platform, facilitating seamless, secure upload and flow of the data from the office and clinic to the cloud for surgical planning. Eyetelligence allows staff to bypass most of the manual labor associated with data processing for surgical planning in favor of uploading that data directly to the cloud. It virtually eliminates the need to print the data from SeeNa and for staff to draw IOL formulas from the web and type that data into the system.

“That’s all time-consuming, it’s open to transcription errors,” Dr. Lobanoff says. “With Eyetelligence, we push one button and all the data is in.”

Summing up the advantages of leveraging a single device that can do the work of two, the surgeons agreed that they come down to maximizing productivity at the lowest possible cost to the practice without sacrificing patient care quality.

“With reimbursements declining, the bottom line is inevitably tied to financial considerations,” 
Dr. Watson observes. “Balancing this fiscal challenge requires a strategic approach, necessitating an increase in patient volume. Any solution that facilitates a more efficient patient flow is undeniably advantageous.”  OM

Disclosures: Dr. Lobanoff is a consultant for Bausch + Lomb on the Eyetelligence platform, which his company, Lochan, built for Bausch + Lomb. Dr. Watson is a beta tester on the Eyetelligence software.