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O P H T H A L M O L O G Y
gy essentially for free to patients already paying for vision upgrades.
The IntraLase laser can't make the capsulorhexis and soften the nucleus like
newer femtosecond systems can, but "that wasn't hugely important to us," says Dr.
Boland. "A lot of patients like the idea of an all-laser, blade-free procedure. This is
one more step along that road."
Dr. Boland, who concedes he added laser cataract surgery partly to market his
center to local patients, doesn't anticipate performing many procedures out of the
chute. Still, he says, it's nice to have the option if patients express interest in it. He
performed his first case in September, and a handful since. His initial patient was
20/25 uncorrected at 1 week post-op. "If I didn't reveal it was a different incision,
you'd never know."
— Daniel Cook
Lawrence Piazza, MD, medical director of Coastal Eye Care and
Coastal Eye Surgery Center in Ellsworth, Maine. In an op-ed piece
written for the Bangor Daily News, he says medical literature fails
to provide definitive clinical proof that lasers contribute to better
or safer visual outcomes than purely manual techniques. He points
to surgeon skill, accurate pre-op eye measurements, proper IOL
selection and placement, treating pre-existing corneal astigmatisms
and removing cataracts without complication as factors in excellent vision outcomes.
Then there's case times to consider, especially in a specialty that
thrives on efficiency. Moving patients from pre-op to the laser room
and finally to the OR can't match than the linear flow of conventional
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O U T PAT I E N T S U R G E R Y M A G A Z I N E O N L I N E | N O V E M B E R 2012
