op inflammation and fewer complications. "It decreases overall
phaco time and the ultrasonic energy dissipated into the eye," says
Mark Rosanova, MD, a surgeon at Hoffman Estates. "Plus, it makes
a perfect capsulorhexis, which prevents peripheral capsular tear-
ing."
However, T. Hunter Newsom, MD, founder of the Newsom Eye &
Laser Center in Tampa, Fla., warns that the evidence thus far that the
laser's increased precision translates to improved outcomes is anec-
dotal. "It's definitely more precise than a surgeon's hand," he says,
"but there's not any significant peer-reviewed data showing that using
a laser for cataract surgery improves safety."
Eye marking
For patients receiving specialty toric or multifocal lenses, it's imper-
ative that the surgeon insert the lens at the correct angle. Otherwise, the
patient may have poor outcomes and require future corrective proce-
dures. To make accurate marks indicating where surgeons must place the
lens, Ms. Carpenter's center recently started using a self-leveling corneal
marker that's pre-inked and comes with sterile disposable tips.
"The marker really helps get an accurate placement of the lens,"
says Ms. Carpenter. "It saves time and is more accurate. Some sur-
geons mark the eye with it, but it's easy enough that most trust our
nurses to do it for them."
Another option is digital marking systems, says Ms. York. In these sys-
tems, the surgeon takes a digital photo of the patient's eye pre-opera-
tively, which is then used to create a map overlay. This map shows the
surgeon information on the patient's astigmatism, axial length, lens
choice and toric correction during the surgery, boosting the doctor's
overall accuracy when making cuts and inserting the lens.
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