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Issue link: https://daily.eyeworld.org/i/1116412
MAY 4, 2019 | SUPPLEMENT TO EYEWORLD DAILY NEWS | 5 ACTIVE SENTRY handpiece Source: Alcon INTREPID Hybrid Tip Source: Alcon CENTURION in the other, and there is no question that the anterior chamber environment is more stable with ACTIVE SENTRY. I had been so impressed with the traditional CENTURION handpiece that I doubted whether this technology would provide anything of benefit to me—and I'm a surgeon with very high parameters because I like the control that CENTURION provides—but when I tried ACTIVE SENTRY, I could tell the difference. The benefits go beyond a more stable intraocular environment during surgery. Because I can use higher vacuum and still feel safe, I am aspirating the nucleus more and using phaco less, so I think I am using less ultrasound energy, which in the long run we know has the potential to be beneficial for the patient. I also think this increases my efficiency, reducing my time inside the eye and fluid usage, which could correlate with less corneal edema postop. Phaco tip selection is another area where I can make personalized decisions based on the patient. A patient with soft to normal nucleus density or lenses that are prefrag- mented with a femtosecond laser are good candidates for the new INTREPID Hybrid Tip. This tip is essentially the same as the INTREPID Balanced Tip, but it has a rounded polymer end that gives it an added safety profile. This softer material, compared to metal, is gentler to intraocular tissue, if encountered during surgery, while still quite effectively emulsifying soft and moderate density nuclei. I also use the LuxOR surgical microscope, which allows me to feel like I have more control when I'm inside the eye because I'm not focusing up and down as much with the foot pedal. This is due to its increased depth of field, which allows me to visualize tissues at var- ious depths in the anterior chamber. Even more important to me is that LuxOR gives me greater visualiza- tion of the entire ocular surface and greater red reflex during cataract surgery because its objective lens is above the light source, compared to most microscopes that have the objective lens below the light source. The latest iteration called the LuxOR Revalia Ophthalmic Microscope will include an LED light source as opposed to halo- gen, which provides better contrast and detail of intraocular tissues. In addition, there are three light source color temperature selections to fur- ther allow the surgeon to customize the surgical procedure. When we talk about customi- zation and personalization, I think it's important to discuss how the ORA SYSTEM with VerifEye+ Technology, in combination with the VERION Image Guided Sys- tem and the LuxOR Microscope, enhances the surgical procedure. This combined system allows me to more accurately align toric IOLs and center multifocal IOLs, and it helps me generate better outcomes by tracking and monitoring my results using the ANALYZOR software. Through this system, I have all my data, which I can bring into discus- sions with patients. For instance, when a patient asks about my results with toric IOLs, I can say that 95% of my patients are within 0.5 D of my intended target. ANALYZOR allows me to quote data to patients, not just give them generalities, and I think that shows my patients that I am a conscientious surgeon who is concerned about achieving the best possible outcome for them. n Editors' note: Dr. Woodard is the medical director at Omni Eye Services of Atlanta. He can be contacted at LWoodard@OmniEyeAtlanta.com.