Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
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cataract surgery under the microscope. A significant number of cataract surgery patients experience post- op floaters, and many of them, like Dr. Bussa, suffer life-altering vision impairment. A lot of those patients were willing to undergo the risks of vitrectomy or silently suffered with the chronic condi- tion. But that's changing, now that surgeons have access to improved YAG laser technology that can vaporize floaters in a mat- ter of minutes. Here are the key clinical factors you and your sur- geons need to consider when adding a new laser platform. • Improved illumination. Vitreolysis isn't a new concept, but the illu- mination systems on previous generations of YAG lasers were not opti- mized to visualize and treat floaters in the middle or posterior vitreous. That limitation increased the difficulty of identifying most floaters that are symptomatic and provided limited spatial context of where floaters sit in relation to the retina and posterior capsule — the perspective surgeons need to provide safe, effective treatment. YAG laser technolo- gy has improved dramatically in recent years. In particular, the ability to view floaters using 2 different illumination positions: coaxial illumi- nation, or "on axis," as well as "off axis," with the slit lamp in the oblique position. In the coaxial position, the laser platform aligns with the surgeon's vision, the target illumination and the treatment beam along the same optical path and the same optical plane. This lets the surgeon focus on-axis with more depth and spatial reference when treating posterior floaters. • Optimized energy. Vitreolysis performed with the latest illumina- tion technology gives surgeons the confidence to use the level of ener- gy needed to effectively vaporize floaters. Physicians who have reported marginal results with vitreolysis in the past often set the YAG laser's energy level to 1.2 millijoules, which is much less than the 4 to 9 millijoules that are typically required to eliminate floaters. Some O C T O B E R 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 9 9