Outpatient Surgery Magazine

Thumbs Up on Safety Scalpels - May 2019 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://outpatientsurgery.uberflip.com/i/1118620

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Page 90 of 112

additional steroids or antibiotics. • And your surgeons might have to insert a three-piece IOL, which is less likely to expand the tear, instead of a two-piece IOL. All of those steps and additional supplies more than double the duration of surgery and inflate your case costs, says Dr. Devgan, stressing that you can't afford to waste minutes and dollars in a vol- ume-driven specialty with razor-thin profit margins. Fortunately, advanced phaco fluidics, femtosecond-lasers and mydriasis-maintaining drugs can help prevent tears from occurring. 1. Room to move Maintaining a pressurized and stable anterior chamber with balanced fluidics lowers the risk of the posterior capsule coming up at the phaco tip as the surgeon is removing parts of the lens nucleus, says Jeffrey Whitman, MD, president and chief surgeon of the Key-Whitman Eye Center in Dallas, Texas. "Equalizing pressure in the eye means the anterior chamber is not as deep, and risk of rupture is higher, but the patient will be more com- fortable," says Dr. Whitman. Newer phaco machines boast advanced fluidics, which give sur- geons more exact control of how much fluid is introduced to the eye than the traditional method of hanging a bottle of balanced salt solu- tion above the patient and relying on gravity to maintain targeted intraocular pressure. Surgeons can now set a target pressure that will avoid creating a shallow anterior chamber while phaco machines automatically deliver the fluid required to maintain that pressure — even when phaco energy is applied, and during irrigation and aspira- M A Y 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 9 1 You never know when something will go wrong. That's what keeps me on my toes. — Jeffrey Whitman, MD

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