When a patient needs cataract surgery, you have a big decision to make: which surgeon is best? Patients rarely know who is the most talented, knowledgeable and compassionate, and they certainly don’t know who has access to the most innovative resources. But we do.
You can follow this checklist to ensure you are identifying the ideal cataract surgeon for your patients.
They Value Your Input
No surgeon or surgical practice can know your patient better after 15 minutes than you do after years as their primary eye doctor. These scenarios highlight valuable information a surgeon may not be privy to, unless you tell them:
- A patient who failed in monovision contact lenses will likely fail in monovision IOLs.
- A patient who is hypersensitive to change may not do well with a multifocal IOL.
- Those with prism in their Rx will require glasses post-op and shouldn’t be offered the hope of being spectacle-free.
You should find a surgeon who is happy to have your input on the patient’s clinical picture. This is a win-win: surgeons gain crucial insight to help them better serve the patient, and the patient receives the individualized care they deserve.
If a surgeon is unwilling to take your clinical insights into consideration, your patients are better served by another option.
They Provide Options
One of the keys to a successful surgery is having options to address every patient’s needs. Ensure your surgeon offers most of these:
- The latest premium IOL technologies, such as the AcrySof IQ Vivity (Alcon), PanOptix (Alcon) or Tecnis Symfony (Johnson & Johnson Vision).
- Toric IOLs for patients with significant astigmatism.
- The Light Adjustable Lens (RxSight).
- Minimally invasive glaucoma surgery (MIGS). Most of these procedures can only be performed at the time of cataract surgery, yet more than 50% of the time, the patient isn’t even offered this option.
- Tools for correcting unexpected refractive outcomes, such as an excimer laser.
Invest in a Surgical Suite
Optometry practices around the country are starting to set up a surgical suite in their office and have the surgeon come to them. This ensures the patient stays with the practice they are comfortable with and they avoid going to an ambulatory surgery center or hospital—which is challenging during COVID-19. It also allows you to share in the professional and surgical fees. This is a far more profitable option for practices referring 20 or more patients per month, and it’s an easy turnkey process if you have the volume and space.
They Have Access to Advanced Technologies
Office-based care is the future for cataract surgery, especially considering the impact COVID-19 has had on hospital-based procedures. Also, an ambulatory surgery center isn’t much different from a hospital operating room, in most patients’ eyes. Other advances that could benefit your patients include:
- Dropless or less drop procedures (e.g., Imprimis Dropless injections at the time of surgery) for patients who don’t do well with topical agents.
- Omidria (topical phenylephrine/ketorolac, Omeros) can help surgeons maintain pupil size, preventing intraoperative miosis and reducing postoperative ocular pain.
- Access to a femtosecond laser or MiLoop (Carl Zeiss) to pre-fragment the lens.
- Zepto (Centricity Vision) can help the surgeon create a perfectly round capsulotomy.
- 3D cataract surgery, for example with the NGenuity system (Alcon).
The future of cataract surgery is filled with unimaginable innovations, such as artificial capsules that allow for future IOL exchange or placement of biometric sensors. So it’s important to partner with surgeons who work with you to provide the latest technologies to your patients. With a strong referral relationship and exceptional comanagement skills, you can deliver the best patient results. n
Note: Dr. Karpecki consults for companies with products and services relevant to this topic.