R
obert Rivera, MD, of
Hoopes Vision in Draper,
Utah,
will speak about his
top 5 pearls for maximiz-
ing outcomes in today's
laser-assisted cataract surgery (LACS)
practice at an EyeWorld education
symposium here at the ASCRS•ASOA
Symposium & Congress.
"For so many years, we talked
our patients out of the belief that
cataract surgery was done with
lasers. Now we find ourselves talking
our patients into believing their
cataract surgery should be done with
a laser," said Dr. Rivera.
When
speaking about reasons
why physicians would want LACS
for their patients, he listed the
following reasons:
• Precision and standardization of
corneal incisions across multiple
surgeons
• Precision of capsulotomy,
including size and centration of
the limbus, pupil, and capsule,
and improvements in effective
lens
position.
• Softening of the nucleus to
minimize phaco
Dr. Rivera said that some doc-
tors not performing LACS have the
"perfect surgeon" mentality. "Some
doctors believe they perform
cataract surgery flawlessly or that
the femtosecond laser doesn't do
anything
better than can be
performed by hand. Others may
consider the femtosecond an
expensive 'toy,' or that their results
are already as good as is possible,"
he said.
The good news is that the most
recent LACS technology addresses
most of these concerns. Many of
these doctors have not seen the
latest LACS lasers in action, not
learned to adapt, and may be left
behind if they continue to wait.
Once a decision has been made
to introduce LACS into a practice,
it is critical to set appropriate
expectations and make the
necessary adjustments for success.
Dr. Rivera has learned several
lessons from his LACS experiences to
date:
• The laser won't sell itself; proper
patient education and counseling
is key.
• A public bias already exists in
favor of laser.
• Patients may not understand
premium IOLs.
• Everybody knows laser is better.
• The largest percentage of patients
opting for LACS is actually the
monofocal group.
• Post-refractive patients are already
familiar with out-of-pocket
payments for premium results.
He shared his 5 top pearls for a
practice considering or in the
process of integrating LACS.
Robert
Rivera, MD
Top 5 pearls for integrating LACS
into a refractive cataract practice
" Dr. Rivera tells
his patients that
LACS makes the
procedure easier
on them, as well
as the surgeon."
Robert Rivera, MD
4
EW
Boston 2014
Saturday, April 26, 2014
Treatment planning options with laser cataract surgery
Axial view of the OCT planning of a lens ablation
continued on page 7
