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The Optometry Times recently posted an in-depth article on the latest operating room technology for ophthalmic patients, written by Tracy Schroeder Swartz, OD, MS. Swartz currently practices at Madison Eye Care Center in Madison, Alabama, with a speciality in anterior segment disorders. She also serves as Education Chair for the Optometric Council for Refractive Technology, and does consulting in the ophthalmic industry.
Advances in phacoemulsification
Modern lens removal occurs using phacoemulsification (phaco), which incorporates ultrasound to emulsify and vacuum to extract a cataractous lens. The ultrasound hand piece is connected to a phaco system, which drives the procedure using settings as dictated by the surgeon. The phaco tip, or fragmentation needle, vibrates at an ultrasonic frequency and emulsifies a cataract when connected to the ultrasonic hand piece. The tip has a hole, which allows the fragmented lens as well as irrigation solution (BSS) to be aspirated.
Femtosecond laser-assisted phacoemulsification
Four platforms are now fully approved in the U.S. for corneal and lens incisions. These include Catalys (Optimedica), LenSx (Alcon Laboratories), LensAR (Lensar) and Victus (Technolas). Most systems create the capsulorhexis, fragment the lens to facilitate removal, and create corneal incisions (see Figure 1). Zeimer FEMTO LVD Z8 (Zeimer Group) received CE approval in Europe in May 2014 for clear corneal incisions, arcuate incisions, capsulotomy, and lens fragmentation, but applications are currently limited to corneal and presbyopia in the U.S. Debate continues regarding whether femtosecond laser-assisted cataract surgery results in superior refractive outcomes, reduced phaco time, improvement in the capsulotomy and corneal incisions, and corneal endothelial cell loss. Total treatment times are longer than manual procedures.
Optiwave Refractive Analysis (ORA) system (WaveTec Vision) measures wavefront aberrometry intraoperatively. The system attaches to the surgical microscope for intraoperative measurements of sphere, cylinder, and axis to aid in IOL power choice in real time (see Figure 2). This is extremely helpful in those patients with a history of keratorefractive surgery, toric IOLs, and presbyopia-correcting IOLs.
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For More Information
The iData report series on ophthalmic devices covers the U.S. and Europe and includes data on markets for OCTs, fundus cameras, slit lamps, perimeters, tonometers, ophthalmic ultrasound systems, corneal topographers, wavefront aberrometers, phacoemulsification consoles, intraocular lenses, and phakic intraocular lenses.
Full reports provide a comprehensive analysis including procedure numbers, units sold, market value, forecasts, as well as detailed competitive market shares and analyses of major players’ success strategies in each market and segment.
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