Iantech's miLoop recently won FDA approval. It employs a thin fila-
ment loop that the surgeon uses to quarter the nucleus. Soft lenses
may then be extracted via aspiration; harder ones still require phaco.
Of those respondents who've already tried this technology, 9% rate it
"very attractive" and another 40% think it's "somewhat attractive."
Many say the device has a real niche with mature cataracts. "There's
nothing wrong with phaco for most cases," says our Philadelphia oph-
thalmologist, "but for the densest cataracts, the addition (not substitu-
tion) of miLoop is a godsend." An Iowa nurse anesthetist likes the sim-
plicity. "One less instrument to fail," he says. A Tennessee ASC admin-
istrator who finds the concept "very attractive" echoes that sentiment:
"Cost is the main reason. Phaco machines are extremely expensive
and technology changes."
The problem is that although the miLoop may reduce the amount of
phaco energy in the eye, phaco is typically still required, says a
Minnesota director of surgical services. It's better for the patient, but
it ends up cutting into profits because reimbursement is fixed. Some
facility managers also question the need for a phaco replacement. "If
it isn't broken, don't fix it," says Daniel Hauer, CASC, administrator of
the Valley Ambulatory Surgery Center in St. Charles, Ill.
"Dropless" cataract surgery
Post-op shots are hot. Drops are not. We asked our survey respon-
dents to rate 2 single injections that surgeons administer at the end of
surgery that treat post-op inflammation and dispense with post-op eye
drops. So-called "dropless" cataract surgery eliminates noncompli-
ance and dosing errors associated with relying on the patient to dis-
pense frequent drops following cataract surgery. There are 2 kinds:
• Antibiotic-steroid. One-third of our survey respondents say their
physicians inject an antibiotic-steroid combination into the posterior
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