Often, informed patients are willing to take that risk. However, an
uninformed patient will likely be very unhappy that she paid premium
prices for a less-than-premium outcome. For your toric lens patients,
you may want to minimize this risk of less-than-perfect vision by
adding corneal refractive procedures to your facility or partnering
with a LASIK center to offer post-op touch-ups.
3. Make post-op
compliance easier
Patients typically must use antibiotic, steroidal and non-steroidal eye
drops several times a day for as long as 3 to 4 weeks after cataract
surgery. Since I was young and healthy (and knew firsthand the con-
sequences of missed drops), compliance wasn't an issue. For many of
your patients, though, that's not always the case.
Dropless surgery involves an intraoperative injection that eliminates
the need for post-op drops. This cuts down on patients' out-of-pocket
expenses and their need to follow a strict post-op regimen. The drop-
less technique does increase your case costs, though, and has not
been proven to dramatically improve outcomes. However, it could
help reduce infections and complications caused by compliance prob-
lems, making everyone involved a little happier.
While some surgeons go dropless for all of their cases, the technique
is really beneficial for certain populations: patients at high risk of
complications or infections, who live alone, are older (70+) and have
a history of problems with compliance.
4. See if a laser is right for you
I remember when the phaco machine was the hot new thing in
cataract surgery. For years, patients would come to me and mistaken-
ly say that they wanted their eyes done "with the laser." While I had to
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