Introducing premium care in the optometrist’s chair

Cataract extraction and replacement of the natural crystalline lens is not a rite of passage marking the transition to senior adulthood or a

Dr. Bloomensteinnegative effect of aging. The procedure should be seen as an opportunity to obtain better quality of vision.  Modern-day cataract surgery has to be viewed as a refractive procedure. Eyecare professionals (ECPs) have the ability and the technology to offer patients the opportunity to see as clearly as when they were in their 20s and 30s, which to many patients is an exciting prospect. Every patient who I diagnose with a cataract is educated about premium surgical care with the ORA System (WaveTec Vision) and how the technology may yield better results with newer lens options.

Talking points

My discussions with patients about cataract and refractive surgery are based on making two points:

• Cataract surgery is one of the safest and most advantageous procedures that eye care professionals can perform.

• It is a one-time opportunity for patients to regain better vision.

The ORA System’s Optiwave technology optimizes intraoperative wavefront data to calculate IOL power and guide standard, premium, or toric IOL selection and limbal relaxing incision (LRI) placement. I also explain to patients that, even though there are a variety of high-quality lenses available, the selected lens is only as good as the measurement that determines its power. The ORA measures true refractive power, and its optimized algorithms produce highly accurate measurements.

As the primary gatekeeper for our patients, we as optometrists need to continually educate our patients about the benefits of new technology related to cataract surgery. Because this surgery is not titratable, we need to make certain the first and only removal of the cataract is done as accurately as possible. The ORA System conveys to our patients that we are partnering in their surgery, we want the most accurate measurement, and we are technologically advanced.

What can the ORA system do?

In my practice, I see a good number of patients who have had previous surgery, whether it is PRK, RK, or LASIK, which presents a challenge when assessing a measurement. Additionally, other obstacles may stand in the way of obtaining an accurate lens measurement, such as astigmatism, measuring patients while they are in a supine position, and small aberrations or distortions that can change the quality of vision. Using a technology that can capture, in vivo, an intraoperative wavefront measurement is ideal for any patient, but especially for patients with challenging circumstances.

Postoperative success

It is not uncommon for the surgeon’s measurement to be off target by 0.50 D or even 0.75 D, creating some patient dissatisfaction. Using ORA can secure a more precise calculation and improve the patient’s acuity. This small dioptral difference can also be a determiner of whether a corrective surgery-such as LRI, PRK, or LASIK-is necessary. When another corrective surgery is needed, the patient may lose confidence in the procedure, the surgeon, and ultimately the optometrist for being involved. Using the ORA System to obtain more precise measurements may yield better patient satisfaction and improve patients’ confidence levels.

What optometrists need to know

The most important thing to remember-something we as ECPs have known for the past 10 to 15 years-is that wavefront aberrometry measurements change when patients have cataracts. The cornea is a stable piece of tissue unless keratorefractive surgery is performed, in which case the cornea and corneal measurements change. Knowing there is a technology that can map out accurate astigmatism is a benefit to us. Optometrists can participate in the evolution of premium surgical care by simply making sure that patients are aware that innovative technology is available and guiding them to a clinic that offers it. Optometrists should build alliances with surgeons who offer different platforms of lenses (such as toric, presbyopic, aspheric) to provide the best quality of vision. Optometrists should also ensure that their philosophy of providing premium surgical care is in line with that of the physician to whom they are referring patients. Speak with the surgeon about his or her philosophies before referring patients there, and then, in turn, inform the patient prior to surgery.

Optometrists have the opportunity to improve patients’ lives. Like most things in life, that chance comes as an added cost to patients-a cost many patients are willing to pay in return for a lifetime of optimal vision.

Let the patient decide whether or not the investment is worthwhile by educating him or her about premium surgical care. Don’t make that decision for the patient. Discuss and guide your patients through the available options that will enable them to not only experience the best quality of vision, but also to see the difference your practice makes.ODT