will receive toric IOLs and those who need to have
their eyes marked before surgery — to treat an
astigmatism, for example. "Pull special instrumenta-
tion or markers in advance of these cases," says Ms.
Wiltshire. "This detailed communication and plan-
ning ahead keeps things running on time."
In the flow
Patients must move along a well-orchestrated path-
way from pre-op to the PACU. When patients arrive
at SightTrust, they're given a pocket lanyard and
badge that displays their name,
the eye or eyes being operated
on, referring doctor, allergies and
additional pertinent information
in bold letters to make it easy for
staff to reference. A surgical tech-
nician then brings the patient to
pre-op and makes sure required
paperwork is on hand before an
anesthesiologist applies dilating eye drops.
Cataract procedures performed at SightTrust
are a two-step process. Patients first enter a proce-
dure room housing a femtosecond laser, which is
used to perform a laser-assisted capsulotomy.
They're then moved to a sterile operating room
outfitted with a phaco machine and surgical micro-
scope. Cataract-affected lenses are emulsified and
aspirated from the eye, and new IOLs are implant-
ed. Part of what makes this movement seamless is
the use of a stretcher chair, which patients ride
from pre-op to recovery. "They
never have to leave the surface
throughout the entire journey,"
says Ms. Wiltshire.
The chairs are also pro-
grammed to change the patient's
position during each stage of the
process, which helps boost effi-
ciency and ease of use for staff.
The first setting is selected in pre-
op, reclining the patient between
30° and 45° (Semi-Fowler's) for
administration of pre-op drops.
When patients are transported to
the laser suite, setting number
two is selected, which puts them
in a recumbent position at a
height that places their eye just
below the laser interface. Setting
three is used in the operating
room to place the patient at a
slightly higher recumbent position
under the surgical microscope. At
the end of the case, setting four is
chosen to return patients to a
near-upright position while
3 2 • O U T P A T I
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N T S U R G E R Y M A G A Z I N E • M A R C H 2 0 2 1
INCREASE
Throughput
ENHANCE
Patient Experience
REDUCE
Patient & Caregiver
Injury
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YOUR OPHTHALMIC SURGERY SOLUTION
"An important aspect of cataract
surgery is to set the appropriate
expectations for patients."
— Andrew C. Shatz, MD
