advantage is they give us greater flexibility to reconfigure rooms, if
needed, or to change things around if and when we invest in new
technology. We bought a phaco machine with high flow rates and high
vacuum levels, which help our surgeons operate faster. We're also
evaluating toric- and IOL-imaging software and might consider adding
it in the future.
Another small detail to consider: If you plan to incorporate optiwave
refractive analysis (ORA), which uses intraoperative wavefront aber-
rometry to measure the refractive power of the eye after the cataract
is removed (so you can be sure you've chosen the most appropriate
IOL), you'll want to make sure you're storing alternative lenses as
near as possible to your ORs. The technology is so precise that you
might implant a different lens than the one you originally planned to
use in about 1 of every 3 cases.
Retina requires a vitrectomy machine, a cryosurgical system, a laser,
an indirect microscope and a large number of disposable instruments.
Since ocular plastics and glaucoma are instrumentation driven, you'll
need a lot of stocking space.
Our retina specialists have recently embraced heads-up 3D technol-
ogy. They have a 50-inch monitor at the foot of the bed and wear a
pair of 3D glasses, so they're never actually looking through the
microscope. Instead, they're looking straight ahead and seeing the
patient's eye in 3 dimensions throughout the procedure. We're also in
the evaluation phase with optical coherence tomography (OCT),
which uses light waves to take cross-section pictures of the retina.
• Laser cataract surgery. Femtosecond lasers make a perfect cap-
sulorhexis; they make perfect incision points and they do a great job
of pre-chopping cataracts. So why wouldn't you outfit your new oph-
thalmic facility with a femto laser? Because there are several other
factors you must consider.
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