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Reduced phaco energy
IanTech's miLoop was introduced in 2017 with the aim of elimi-
nating, or at least significantly reducing, the need for pha-
coemulsification energy to fragment cataracts before removal.
Surgeons insert the pen-like miLoop through a 1.5 mm corneal inci-
sion, slide the device's filament loop in the open position around the
cataract's nucleus and activate the device's finger lever to halve the
nucleus. Surgeons can remove the fragments of soft lenses with only
aspiration, but often employ low levels of phaco energy to chop up
the fragmented remains of denser cataracts.
Ophthalmic surgeon William Trattler, MD, uses the miLoop in only
about 4% of his cases, but appreciates having it nearby to fragment
very dense cataracts before dialing back the phaco energy to finish
the job. "Less energy translates into lower risk of corneal edema and
less inflammation in the anterior chamber," points out Dr. Trattler,
who operates at the Center for Excellence in Eye Care in Miami, Fla.
Despite its slick design and proven clinical performance, the miLoop
has yet to gain widespread acceptance among cataract surgeons who
don't see the need to alter the fundamentals of a safe and effective
procedure. Cost of the single-use miLoop — about $130 per case — is
also a legitimate concern in a specialty with razor-thin profit margins,
according to Dr. Trattler. He admits surgeons in larger multi-specialty
facilities might be more inclined to use the device than budget-con-
scious physician-owners of eye-only centers who case cost down to
the penny.
Still, he believes the miLoop deserves a spot on a cataract surgeon's
preference card. "They can reach for it when it will make a clear clini-
cal difference during advanced cases," he says. "When I need it, I'm
very happy to have it in my toolbox."
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